Intracranial hypotension

Case contributed by Huda B. Gharbia
Diagnosis almost certain

Presentation

Postural headache, vertigo, blurred vision, nausea and vomiting.

Patient Data

Age: 35 years
Gender: Female
ct

Bilateral subdural collection, obliterating subarachnoid spaces in suprasellar cistern and perimesencephalic cistern.

mri

Bilateral subdural collection, no clear evidence of hematoma.

Diffuse distended dural venous sinuses, drooping splenium of the corpus callosum, markedly narrowed interpeduncular angle, and mamillopontine distance, sagging brainstem.

Enlargement of pituitary gland.

Diffuse dural thickening and enhancement post contrast.

Case Discussion

The imaging findings are related to reduced CSF volume.

In this case no history of any previous intervention or surgery, suggestive of spontaneous intracranial hypotension.

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