Radiology Case Reports (Oct 2019)

Spontaneous intracranial hypotension in a patient with systemic lupus erythematosus

  • Dan Isaac Cohen-Addad, MD,
  • Aslan Efendizade, DO,
  • Arkadij Grigorian, MD,
  • Kevin Hewitt, DO,
  • Vinodkumar Velayudhan, DO

Journal volume & issue
Vol. 14, no. 10
pp. 1188 – 1192

Abstract

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ABSTRACT: Spontaneous intracranial hypotension (SIH) associated with cerebrospinal fluid leak classically presents with postural headache. It is most commonly caused by the spontaneous dehiscence of a meningeal diverticulum or as a consequence of dural tears. The association between connective tissue disease and SIH is well known. However, the occurrence of SIH associated with systemic lupus erythematosus has rarely been reported. We present a 53 years old female with a history of systemic lupus erythematosus who was diagnosed with SIH. The patient was worked up with Magnetic resonance imaging and Computed tomographic myelography, and successfully treated with a nontargeted epidural blood patch. Furthermore, we review the current literature and focus on the various imaging techniques that can be used in the workup of a cerebrospinal fluid leak. Keywords: Spontaneous intracranial hypotension, Systemic lupus erythematous, CSF leak, Pachymeningeal enhancement, Venous engorgement, CT myelography