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Published on: March 21, 2013
[Spontaneous intracranial hypotension syndrome: two case reports]
Lucía Diaz-Cabanas1, Ángel Prieto-Gonzalez, Carla Frieiro-Dantas
1Servicio de Neurocirugía, Hospital Clinico Universitario de Santiago de Compostela, Santiago de Compostela, Espana. luciadc@hotmail.es
Revista De Neurologia
|February 27, 2013
Summary
Spontaneous intracranial hypotension, often due to spinal cerebrospinal fluid leaks, causes debilitating headaches. Prompt diagnosis and epidural blood patch treatment are key for symptom relief.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Spontaneous intracranial hypotension (SIH) arises from spinal cerebrospinal fluid (CSF) leaks, presenting with orthostatic headaches and diverse neurological symptoms.
- Diagnostic challenges in SIH stem from its varied clinical manifestations, complicating timely identification and management.
Observation:
- Two cases of SIH with orthostatic headaches and subdural collections on neuroimaging are presented.
- Both patients were diagnosed with spinal CSF leaks and successfully treated with epidural blood patches.
Findings:
- Magnetic resonance imaging (MRI) with gadolinium enhancement of the pachymeninges is crucial for SIH diagnosis.
- Spinal MRI, CT myelography, and radionuclide cisternography aid in localizing CSF leaks.
Implications:
- Early diagnosis and intervention, primarily epidural blood patching, are vital for managing SIH.
- Surgical intervention is reserved for refractory cases, highlighting the importance of conservative treatment options.
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