[Intracranial hypotension syndrome in a pediatric patient with Marfan syndrome]

Area of Science:

• Neurology
• Pediatrics
• Radiology

Background:

• Intracranial hypotension syndrome (IHS) is characterized by reduced cerebrospinal fluid (CSF) pressure, often presenting as orthostatic headache.
• IHS can be spontaneous or secondary to trauma, surgery, or systemic conditions.
• Marfan syndrome, a connective tissue disorder, may predispose individuals to conditions causing CSF leaks.

Observation:

• An 11-year-old boy with Marfan syndrome experienced orthostatic headache and vomiting after a fall.
• Magnetic resonance imaging revealed extradural fluid collections, indicative of a CSF leak.
• The patient had recurrent episodes of IHS despite initial treatment.

Findings:

• The case demonstrates a pediatric presentation of IHS secondary to a likely CSF leak following trauma in a patient with Marfan syndrome.
• Recurrent symptoms necessitated a delayed epidural blood patch for resolution.
• This case underscores the diagnostic challenge of IHS in children, particularly those with underlying connective tissue abnormalities.

Implications:

• Pediatric IHS should be considered in children presenting with orthostatic headaches, especially those with connective tissue disorders.
• Further research is needed to establish optimal management strategies for IHS in the pediatric population.
• This case contributes valuable data to the limited literature on pediatric IHS management.