Objective Study the imaging characteristics of spontaneous intracranial hypotension(SIH) and the effect of epidural infusion treatment.Methods Clinical data of one patient with SIH was retrospective analysis.Results The patient presented with symptoms of postural headache,nausea,vomiting;pressure of cerebrospinal fluid(CSF) couldn't be measured.Cranial MRI found typical subdural fluid collections,diffuse thickening of the pachymeninges with enhancement,engorgement of venous sinuses,enlargement of the pituitary gland,and downward displacement of the brain.High-resolution CT myelography precisely located the site of CSF leak.Epidural infusion of normal saline relieved immediately the symptom of intracranial hypotension.Conclusions The imaging characteristics of SIH includes engorgement of venous sinuses,diffuse thickening of the pachymeninges with Gd enhancement,subdural fluid collections.The treatment with epidural infusion for SIH is very effectual.