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Volume : 23 Issue : 4 Year : 2017

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A rare presentation of spontaneous intracranial hypotension [Turk J Neurol]
Turk J Neurol. Ahead of Print: TJN-98624

A rare presentation of spontaneous intracranial hypotension

Cihat Uzunköprü1, Volkan Çakır2, Şehnaz Arıcı1, Yeşim Beckmann1
1Department of Neurology, Katip Çelebi University, İzmir, Turkey
2Department of Radiology, Katip Çelebi University, İzmir, Turkey

A 55-year-old man presented with coma induced by spontaneous intracranial hypotension. In magnetic resonance imaging, sagging and restricted diffusion in the splenium of the corpus callosum, diffuse pachymeningeal enhancement, and bilateral subdural hematomas were observed. Cerebrospinal fluid leakage was detected in thoracic spine and the patient was treated with a targeted epidural blood patch. After the treatment, lesion in the corpus callosum disappeared without any residual abnormality and the patient fully recovered. Spontaneous intracranial hypotension can be life threatening and result in various clinical manifestations from mild orthostatic headache to deep coma. Targeted epidural blood patch treatment seems effective and life saving. Spontaneous intracranial hypotension should be considered in the differential diagnosis of transient corpus callosum splenium lesion.

Keywords: Corpus callosum splenium, spontaneous intracranial hypotension, coma, epidural blood patch

Corresponding Author: Cihat Uzunköprü, Türkiye

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