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Updated: Sep 15, 2026

Massive Pontine Hemorrhage by Dual Injection of Autologous Blood
Published on: May 29, 2021
Spontaneous intracranial hypotension complicated by malignancyinduced disseminated intravascular coagulation: A case
Hung-Yi Wu1, Shu-Shya Hseu2, Shih-Pin Chen1
1Department of Neurology, Neurological Institute; Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan.
Purpose:
Spontaneous intracranial hypotension (SIH) is a rare type of headache. The association of SIH with malignancy and disseminated intravascular coagulation (DIC) has not previously been reported.
Case Report:
A 60-year-old woman had orthostatic headache for more than one month before admission. MRI of brain showed diffuse pachymeningeal enhancement with bilateral subdural hematoma. MR myelography revealed epidural fluid collection and possible CSF leakage at the level of C5 to C6. DIC due to carcinoma of unknown origin was found based on evidence of malignant pleural effusion and multiple bone metastases. After correction of coagulopathy, the patient received an epidural blood patch. Unfortunately, follow-up brain MRI showed disease progression. The patient died of acute respiratory failure four weeks after admission.
Conclusion:
This is the first case report of an association between SIH and DIC due to malignancy. Further case studies are needed to provide further support of this association.
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