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Subdural hematoma in a patient with spontaneous intracranial hypotension and cerebral venous thrombosis

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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.

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References

  1. Rando TA, Fishman RA (1992) Spontaneous intracranial hypotension: report of two cases and review of the literature. Neurology 42:481–487

    CAS  PubMed  Google Scholar 

  2. Miyazawa H, Shiga Y, Hasegawa T et al (2003) CSF hypovolemia vs intracranial hypotension in “spontaneous intracranial hypotension syndrome”. Neurology 60:941–947

    CAS  PubMed  Google Scholar 

  3. 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

    Article  PubMed  Google Scholar 

  4. Sopelana D, Marcos A, Arroyo R et al (2004) May intracranial hypotension be a cause of venous sinus thrombosis? Eur Neurol 51:113–115

    Article  CAS  PubMed  Google Scholar 

  5. Flemming KD, Link MJ (2005) Spontaneous CSF leak complicated by venous thrombosis and dural arteriovenous fistula. Cephalalgia 25:751–753

    Article  CAS  PubMed  Google Scholar 

  6. Kataoka H, Tanizawa E, Ueno S (2007) Spontaneous intracranial hypotension is associated with a risk of venous thrombosis. Cerebrovasc Dis 23:315–317

    Article  PubMed  Google Scholar 

  7. Jacobs K, Moulin T, Bogousslavsky J et al (1996) The stroke syndrome of cortical vein thrombosis. Neurology 47:376–382

    CAS  PubMed  Google Scholar 

  8. Monroe J (1783) Observations on the structures and functions of the nervous system. Creech, Edinburgh

  9. Kellie G (1824) An account with some reflections on the pathology of the brain. Edinburgh Med Chir Soc Trans 1:84–169

    Google Scholar 

  10. Sipe JC, Zyroff J, Waltz TA (1981) Primary intracranial hypotension and bilateral isodense subdural hematomas. Neurology 31:334–337

    CAS  PubMed  Google Scholar 

  11. Mokri B, Piepgras DG, Miller GM (1997) Syndrome of orthostatic headaches and diffuse pachymeningeal gadolinium enhancement. Mayo Clin Proc 72:400–413

    Article  CAS  PubMed  Google Scholar 

  12. Chung SJ, Kim JS, Lee MC (2000) Syndrome of cerebral spinal fluid hypovolemia: clinical and imaging features and outcome. Neurology 55:1321–1327

    CAS  PubMed  Google Scholar 

  13. Schievink WI, Maya MM, Moser FG, Tourje J (2005) Spectrum of subdural fluid collections in spontaneous intracranial hypotension. J Neurosurg 103:608–613

    Article  PubMed  Google Scholar 

  14. Lai TH, Fuh JL, Lirng JF, Tsai PH, Wang SJ (2006) Subdural haematoma in patients with spontaneous intracranial hypotension. Cephalalgia 27:133–138

    Article  Google Scholar 

  15. Wiesemann E, Berding G, Goetz F, Windhagen A (2006) Spontaneous intracranial hypotension: correlation of imaging findings with clinical features. Eur Neurol 56:204–210

    Article  PubMed  Google Scholar 

  16. Nakajima H, Sakai T, Aoki N, Takakura K (1996) Bilateral chronic subdural haematomas associated with intracranial hypotension. Neurol Med Chir 36:647–649

    Article  CAS  Google Scholar 

  17. 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

    Article  CAS  PubMed  Google Scholar 

  18. 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

    Article  PubMed  Google Scholar 

  19. Stam J (2005) Thrombosis of the cerebral veins and sinuses. N Engl J Med 352:1791–1798

    Article  CAS  PubMed  Google Scholar 

  20. 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

    Article  PubMed  Google Scholar 

  21. Chiapparini L, Farina L, D’Incerti L et al (2002) Spinal radiological findings in nine patients with spontaneous intracranial hypotension. Neuroradiology 44:143–150

    Article  CAS  PubMed  Google Scholar 

  22. 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

    Article  PubMed  Google Scholar 

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Correspondence to Raffaele Nardone.

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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

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  • DOI: https://doi.org/10.1007/s10072-010-0389-z

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