Spontaneous intracranial hypotension: a report of a case with bilateral SDH

초록

목적: spontanoeus intracranial hypotension is characterized by postural headache and low opening pressure at lumbar puncture without obvious cause. It's character is typical but it's quite difficult to diagnosis. We report a case with bilateral subdural hematoma(SDH) 대상: A 37-year old man was admitted to our hospital with sudden headache, both opthalmalia and posterior nuchal pain. The nature of his headache was continouw sqeezing , and changing his position to flat position provided pain relief. One week before his admission, he experiedncec continous cough and the rhinorrhae. during a few days. On admission, his neuological examination revealed no neurothickenng and intense contrast ehhancement of the dural mater and bilateral frontotemproal subdural fluid collection mixed with blood. Radioisotope cisternographu showed a leak of cerebrospinal fluid from near the lower lumbar vertebrae. 결과: After burr hole drainage, the heada？？ was relieved. And follow up CT showed no bialteral SDH. Headache did not recur for 2 weeks after surgery. The continous cough before her admission may be the caude of the leak of cerebrospirnal fluid but it was unclear. 결론:Most patientw with SDH are incorrectly diagnosed with significant delqy in correc diagnosis. Headac도 is the most common presenting symptoms, and SIH should be considered as the diagnosis by physicials who care for patient with headac도. Careful history taking and examination should be done. After diagnosis, the proper management is needed.