A Rare Presentation of Spontaneous Intracranial Hypotension

Cihat Uzunköprü; Volkan Çakır; Şehnaz Arıcı; Yeşim Beckmann

doi:10.4274/tnd.98624

Cihat Uzunköprü¹, Volkan Çakır², Şehnaz Arıcı¹, Yeşim Beckmann¹

¹Katip Celebi University Faculty of Medicine, Department of Neurology, Izmir, Turkey
²Katip Celebi University Faculty of Medicine, Department of Radiology, Izmir, Turkey

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

Abstract

A 55-year-old man presented with coma induced by spontaneous intracranial hypotension (SIH). 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 the thoracic region and the patient was treated with a targeted epidural blood patch. After the treatment, the lesion in the corpus callosum disappeared without any residual abnormality and the patient fully recovered. SIH 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 lifesaving. SIH should be considered in the differential diagnosis of transient corpus callosum splenium lesion.