[Spontaneous cerebrospinal fluid hypotension: value of cerebral MRI]

Spontaneous intracranial hypotension is uncommon. Clinically it consists mainly of postural headache associated with CSF pressure lower than 5 cm H2O. Recently it has been reported that in this syndrome cerebral MRI shows diffuse and symmetrical meningeal enhancement increasing with Gadolinium and disappearing spontaneously without any particular treatment. We report the cases of two women in whom CSF pressure, several weeks after the appearance of headache, was in normal limits and whose cerebral MRI showed such meningeal enhancement. Meningeal biopsy in a search for chronic pachymeningitis was normal in both cases. Diagnosis was established afterwards in the light of recent publications.