Spontaneous Intracranial Hypotension with Subdural Hemorrhage Requiring Evacuation: A Report of Two Cases

Spontaneous intracranial hypotension (SIH) is caused by cerebrospinal fluid leakage and subsequent hypovolemia in the spinal subarachnoid membrane or, rarely, the intracranial space. Subdural fluid collection is a rare complication of SIH caused by the persistence of negative pressure. This report describes a case of SIH with subdural fluid collection in a patient who underwent surgical hematoma evacuation before an epidural blood patch (EBP). A 60-year-old man and 43-year-old man were initially diagnosed with SIH secondary to an orthostatic headache that became exacerbated. Brain computed tomography revealed subdural hemorrhage (SDH). Because their condition deteriorated gradually, they underwent burrhole trephination to evacuate the SDH. An epidural blood patch was applied to treat the remaining symptoms of SIH after evacuation. During the next 3 days, headache completely resolved with satisfactory results. We report this case of SIH with SDH resulting in surgical hematoma evacuation before EBP that successfully resolved. KCI Citation Count: 0