Abstract
We report a patient with clinical and neuroimaging findings of spontaneous intracranial hypotension (SIH) who developed cerebral venous thrombosis (CVT). An association between SIH and CVT has rarely been observed. Anticoagulation therapy was administered. The clinical course was subsequently complicated by a large subdural hematoma that required neurosurgical evacuation. The present report indicates that SIH should not be always considered a benign condition, especially when associated with CVT and subdural fluid collections. Furthermore, clinicians should be aware of the potential risks of anticoagulant therapy in patients with SIH and CVT.
Similar content being viewed by others
References
Rando TA, Fishman RA (1992) Spontaneous intracranial hypotension: report of two cases and review of the literature. Neurology 42:481–487
Miyazawa H, Shiga Y, Hasegawa T et al (2003) CSF hypovolemia vs intracranial hypotension in “spontaneous intracranial hypotension syndrome”. Neurology 60:941–947
Berroir S, Grabli D, Heran F, Bakouche P, Bousser MG (2004) Cerebral sinus venous thrombosis in two patients with spontaneous intracranial hypotension. Cerebrovasc Dis 17:9–12
Sopelana D, Marcos A, Arroyo R et al (2004) May intracranial hypotension be a cause of venous sinus thrombosis? Eur Neurol 51:113–115
Flemming KD, Link MJ (2005) Spontaneous CSF leak complicated by venous thrombosis and dural arteriovenous fistula. Cephalalgia 25:751–753
Kataoka H, Tanizawa E, Ueno S (2007) Spontaneous intracranial hypotension is associated with a risk of venous thrombosis. Cerebrovasc Dis 23:315–317
Jacobs K, Moulin T, Bogousslavsky J et al (1996) The stroke syndrome of cortical vein thrombosis. Neurology 47:376–382
Monroe J (1783) Observations on the structures and functions of the nervous system. Creech, Edinburgh
Kellie G (1824) An account with some reflections on the pathology of the brain. Edinburgh Med Chir Soc Trans 1:84–169
Sipe JC, Zyroff J, Waltz TA (1981) Primary intracranial hypotension and bilateral isodense subdural hematomas. Neurology 31:334–337
Mokri B, Piepgras DG, Miller GM (1997) Syndrome of orthostatic headaches and diffuse pachymeningeal gadolinium enhancement. Mayo Clin Proc 72:400–413
Chung SJ, Kim JS, Lee MC (2000) Syndrome of cerebral spinal fluid hypovolemia: clinical and imaging features and outcome. Neurology 55:1321–1327
Schievink WI, Maya MM, Moser FG, Tourje J (2005) Spectrum of subdural fluid collections in spontaneous intracranial hypotension. J Neurosurg 103:608–613
Lai TH, Fuh JL, Lirng JF, Tsai PH, Wang SJ (2006) Subdural haematoma in patients with spontaneous intracranial hypotension. Cephalalgia 27:133–138
Wiesemann E, Berding G, Goetz F, Windhagen A (2006) Spontaneous intracranial hypotension: correlation of imaging findings with clinical features. Eur Neurol 56:204–210
Nakajima H, Sakai T, Aoki N, Takakura K (1996) Bilateral chronic subdural haematomas associated with intracranial hypotension. Neurol Med Chir 36:647–649
Sato Y, Honda Y, Maruoka H, Kunoh H, Oizumi K (1998) Subdural haematoma following disappearance of orthostatic headache and pressure normalization in two patients with spontaneous intracranial hypotension. Cephalalgia 18:60–63
De Noronha RJ, Sharrack B, Hadjivassiliou M, Romanowski CAJ (2003) Subdural haematoma: a potentially serious consequence of spontaneous intracranial hypotension. J Neurol Neurosurg Psychiatry 74:752–755
Stam J (2005) Thrombosis of the cerebral veins and sinuses. N Engl J Med 352:1791–1798
Schievink WI, Maya MM, Pikul BK, Louy C (2010) Spontaneous spinal cerebrospinal fluid leaks as the cause of subdural haematomas in elderly patients on anticoagulation. J Neurosurg 112(2):295–299
Chiapparini L, Farina L, D’Incerti L et al (2002) Spinal radiological findings in nine patients with spontaneous intracranial hypotension. Neuroradiology 44:143–150
Thomas DL, Menda Y, Graham MM (2009) Radionuclide cisternography in detecting cerebrospinal fluid leak in spontaneous intracranial hypotension: a series of four case reports. Clin Nucl Med 34(7):410–416
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Nardone, R., Caleri, F., Golaszewski, S. et al. Subdural hematoma in a patient with spontaneous intracranial hypotension and cerebral venous thrombosis. Neurol Sci 31, 669–672 (2010). https://doi.org/10.1007/s10072-010-0389-z
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10072-010-0389-z