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Published on: June 18, 2021
Atypical presentations and long-term sequelae of spontaneous intracranial hypotension: illustrative cases
Danial Nasiri1, Levin Häni1, Alexis P R Terrapon1
1Department of Neurosurgery, Inselspital, Bern University Hospital, University of Bern.
Background:
Spontaneous intracranial hypotension (SIH) is typically recognized by orthostatic headache and characteristic neuroimaging findings such as brain sagging and dural enhancement, but atypical manifestations and long-term sequelae remain underreported.
Observations:
The authors present 5 cases that illustrate uncommon SIH presentations and complications, including reversible cerebral vasoconstriction syndrome, sinus vein thrombosis, ventral spinal cord herniation, thoracic meningocele, secondary Arnold-Chiari malformation type I, and superficial siderosis.
Lessons:
SIH may present with diverse complications beyond orthostatic headache; awareness and follow-up imaging are important for timely diagnosis and management. https://thejns.org/doi/10.3171/CASE26236.
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