EC Neurology

Spontaneous intracranial hypotension (SIH) is a rare neurological disorder caused by cerebrospinal fluid (CSF) leakage, leading to reduced intracranial CSF pressure. This case report presents the clinical course and management of a healthy 44-year-old adult male who presented to the emergency department with a two-day history of fatigue and a severe headache. The primary symptom of SIH is an orthostatic headache that worsens upon standing and improves upon lying down. The patient underwent various imaging modalities, including brain and spinal computed tomography (CT) and magnetic resonance imaging (MRI), which confirmed the diagnosis of spontaneous intracranial hypotension due to CSF leakage. The treatment plan involved conservative measures, including bed rest, IV caffeine, and dexamethasone, followed by targeted epidural blood patching. Although the first epidural blood patch failed, a second attempt was successful in resolving the headache. The patient showed significant improvement in his symptoms and level of consciousness and was eventually discharged without any residual neurological deficits. This case highlights the importance of early diagnosis and appropriate management of SIH to prevent complications and improve patient outcomes. Clinicians should consider SIH in the differential diagnosis of postural headaches, especially in patients with a history of CSF leaks or connective tissue disorders. Early recognition and intervention are crucial to achieve favorable outcomes in patients with SIH.

 Keywords: Headache; Spontaneous Intracranial Hypotension; CSF Leakage; Healthy Adult; Neurosurgery

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