Intracranial hypotension

Case contributed by Khalid Alhusseiny
Diagnosis almost certain

Presentation

A female patient presented to the ER complaining of a headache with a past history of a cesarian section about two months earlier.

Patient Data

Age: 25 years
Gender: Female
mri

Bilateral small subdural collections are seen overlying both cerebral hemispheres showing increased signal intensity on T2WI and areas of blooming on SWI. The lateral ventricles are attenuated. Following contrast injection, there is diffuse pachymeningeal enhancement.

ct

Bilateral subdural collections with mild hyperdensity along the falx cerebri.

Case Discussion

Secondary intracranial hypotension occurs due to CSF leak. In this case, the leak was a consequence of the lumbar puncture performed during cesarian section.

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