Coma in spontaneous intracranial hypotension complicated with subdural hematoma: a case report
10.3760/cma.j.cn113694-20210925-00668
- VernacularTitle:自发性低颅压合并硬膜下血肿继发昏迷1例
- Author:
Zhen WANG
1
;
Yanfang DAI
;
Yanhong AN
;
Yanhui MA
;
Jie WU
;
Dezhou QI
;
Jingjing SUN
;
Hong YE
;
Ran GAO
;
Junjie LI
;
Liyong WU
Author Information
1. 首都医科大学宣武医院神经内科，北京100053
- Keywords:
Intracranial hypotension;
Hematoma, subdural;
Coma;
Trepanation and drainage;
Targeted epidural blood patch
- From:
Chinese Journal of Neurology
2022;55(4):349-353
- CountryChina
- Language:Chinese
-
Abstract:
Spontaneous intracranial hypotension can frequently result in several complications including subdural hygroma, subdural hematoma and cerebral venous thrombosis, but coma rarely. A case of spontaneous intracranial hypotension presented with orthostatic headaches was described. He experienced somnolence, disorientation, incontinence, and then coma, though received conservative treatment. Brain imaging demonstrated acute-on-chronic subdural hematoma, magnetic resonance myelography using heavily T 2-weighted fast spin-echo pulse sequences showed spinal longitudinal extradural collection, and magnetic resonance myelography with intrathecal gadolinium revealed cerebrospinal fluid leak at the level of T 6, T 7. The patient recovered consciousness after surgical evacuation of the hematoma, and the headache disappeared after a targeted epidural blood patch. The hematoma resolved 2 months later and the patient kept free from headache during follow-up.
