Intracranial Hypotension Syndrome with Cortical Venous Thrombosis: A Rare Case

Abstract

A married woman aged 31 years who was a vegetarian presented with symptoms of fever with orthostatic throbbing headache, which she had for 7 days. Lumber puncture with manometry showed a low pressure of 40 mmH2O. Magnetic resonance imaging of the brain showed prominent bilateral symmetric pachymeningeal enhancement with prominent engorged venous sinuses suggestive of intracranial hypotension syndrome. Magnetic resonance venography showed non-visualization of the left transverse and sigmoid sinus suggestive of cortical venous thrombosis. Spontaneous intracranial hypotension, though rare is a real risk factor for cortical venous thrombosis. A high degree of suspicion is needed for a timely diagnosis.