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Spontaneous intracranial hypotension: a case report
Serap Uysal1, Sait Albayram, Tugba Erener Ercan
1Istanbul University Cerrahpasa Medical Faculty, Department of Neuroradiology, Istanbul, Turkey.
Journal of Child Neurology
|November 6, 2008
Summary
Spontaneous intracranial hypotension, a condition of low cerebrospinal fluid pressure, can affect children. A pediatric case highlights headache and ataxia resolution after a blood patch, though hearing loss persisted.
Area of Science:
- Neurology
- Pediatrics
Background:
- Spontaneous intracranial hypotension (SIH) is a rare condition characterized by low cerebrospinal fluid (CSF) pressure, often caused by spontaneous CSF leaks.
- Orthostatic headache is the primary symptom, significantly impacting quality of life.
Observation:
- A 5-year-old girl presented with a month-long history of headache, sudden hearing loss, and ataxia.
- Magnetic resonance imaging (MRI) revealed an enlarged cervical venous plexus.
- Lumbar puncture indicated low CSF opening pressure, and magnetic resonance myelography identified a CSF leak at the L3-L4 vertebral level.
Findings:
- Conservative treatments, including bed rest and caffeine, were ineffective.
- A lumbar epidural blood patch successfully resolved the headache and ataxia.
- Hearing loss did not improve after the initial blood patch or a subsequent one.
Implications:
- SIH should be considered in the differential diagnosis of pediatric headaches, even with atypical symptoms like hearing loss.
- The case underscores the effectiveness of epidural blood patches for SIH-related neurological deficits in children.
- Persistent hearing loss suggests potential for non-resolving complications despite successful treatment of other symptoms.
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