TITLE:
Spontaneous Intracranial Hypotension: An Interesting Cause of Intractable Headache
AUTHORS:
Kiran Kumar, Himanshi Singh, Sameh Saied, Mohammed Hamdy Ibrahim, Mohammed Khalid, Rifah Anwar Assadi, Sonia Lamichhane, Shaikh Altaf Basha, Rajashree Ganesh, Neha Arora
KEYWORDS:
Intracranial Hypotension, Headache, CSF Leak, Orthostatic Headache
JOURNAL NAME:
Neuroscience and Medicine,
Vol.6 No.3,
September
15,
2015
ABSTRACT: Intracranial hypotension (ICH) is a benign syndrome which is often under-diagnosed. It is characterized by orthostatic headache which is predominantly occipital. ICH is diagnosed in the presence of a typical history and characteristic imaging findings. Further confirmation by lumbar puncture to document low CSF pressure might be necessary in some cases. Treatment is mainly conservative in the form of bed rest and intravenous saline infusion. However, surgical intervention may be required if conservative measures fail. In this report we presented a case of 42-year-old male patient who presented with symptoms of orthostatic occipital headache of three-month duration and was subsequently diagnosed with intracranial hypotension based on characteristic MRI findings of pachymeningeal enhancement on gadolinium enhanced MRI of the brain with sagging of the mid-brain.