TITLE:
Recurrent Intracranial Hypotension Complicated with Subdural Hematoma—A Case Report and a Case Series Review
AUTHORS:
Chi-Man Yip
KEYWORDS:
Epidural Blood Patch, Intracranial Hypotension, Orthostatic Headache, Subdural Hematoma
JOURNAL NAME:
Open Journal of Modern Neurosurgery,
Vol.12 No.4,
October
24,
2022
ABSTRACT: Intracranial hypotension has variable clinical manifestations;
subdural hematoma is one of the complications of intracranial
hypotension with the reported incidence ranging from 16% to 57%. The author
would like to share a case of subdural hematoma caused by recurrent
intracranial hypotension with different cerebrospinal fluid (CSF) leakage site
and to review a case series of intracranial hypotension treated in the author’s
hospital (Kaohsiung Veterans General Hospital). A 44-year-old male having the
past history of intracranial hypotension was treated in our Neurology division one month previous to this admission, who
was sent to our emergency room (ER) due to severe orthostatic headache with nausea and vomiting. Computed tomography (CT)
scan of brain at ER showed bilateral subdural hematoma, more on the left side with mass effect. Both surgical removal of the subdural hematoma and epidural blood patch were performed and he had a
good outcome. Orthostatic headache is
a specific symptom sign of intracranial hypotension. Epidural blood
patch is effective to manage intracranial hypotension either the leakage site
of CSF is detected or not. In case of non-traumatic subdural hematoma,
intracranial hypotension should be kept in mind.