Treatment for spontaneous intracranial hypotension associated with cerebral venous thrombosis resulting in severe neurologic deterioration

Abstract

Spontaneous intracranial hypotension is an uncommon condition, caused by spontaneous leakage of cerebrospinal fluid (CSF), but well-known cause of orthostatic headache. Although subdural fluid collection is a usual complication of SIH, SIH as a risk factor for cerebral venous thrombosis is not well known and a causal relationship has not been clearly established. Generally, spontaneous intracranial hypotension alone has been known to show clinically benign course, but this complication like cerebral venous thrombosis can be seizure and/or life threatening course. Each treatment for spontaneous intracranial hypotension and cerebral venous thrombosis is well known, however, its indication and treatment methods, in the setting of concurrent spontaneous intracranial hypotension with cerebral venous thrombosis is unknown, especially in severe neurologic deterioration status. Herein, we report a case of a patient was treated with emergency epidural blood patch followed by intra-venous direct thrombectomy and anticoagulant therapy for spontaneous intracranial hypotension complicated by cerebral venous thrombosis and would like to discuss treatment.

Keywords

• Spontaneous intracranial hypotension
• Cerebral venous thrombosis