, Volume 32, Issue 5, pp 981-983
Date: 06 Aug 2011

Delayed subdural hematoma and cerebral venous thrombosis in a patient with spontaneous intracranial hypotension

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Dear Sir,

Spontaneous low cerebrospinal fluid (CSF) pressure syndrome, first described by Schaltenbrand in 1938 [1], is an uncommon but increasingly recognized disease. This syndrome is defined by CSF pressures of 70 mmH2O or less in the lateral position and no history of injuries. Severe complications of this syndrome such as subdural hemorrhage (SDH) and cerebral venous thromboses (CVT) have been rarely reported. In this letter, we discuss a case of this syndrome accompanied by both SDH and CVT.

A 34-year-old man presented with diffuse holocranial headache and no history of injuries on 27 September 2007. The pain resolved on recumbency and occurred while sitting and standing, and was relieved in 1 day. The patient again developed orthostatic headache 6 days later which was more severe than the first headache. A computed tomography (CT) scan indicated abnormal superior sagittal sinus (SSS) and straight sinus (Fig. 1a). The patient’s neurological examination showed only neck stiffness. T