[Chronic subdural hematoma organized over a short period of time with spontaneous intracranial hypotension: a case report]

Brain Nerve. 2012 Jul;64(7):855-60.
[Article in Japanese]

Abstract

Spontaneous intracranial hypotension (SIH) can develop after cerebrospinal fluid (CSF) leakage and is accompanied by various symptoms, including headache and neck pain. In recent years, cases of chronic subdural hematoma (CSDH) that develop concomitantly with SIH have been encountered occasionally. Although various reports regarding the priority of treatment exsist, a conclusive opinion has yet to be given. Here, we present a rare case of CSDH that developed concomitantly with SIH in which the hematoma became organized over a short period of time. Organized CSDH results from impairment of the microcirculation due to metabolic or circulatory dysfunction or inflammation after trepanation. The disease is believed to require craniotomy for treatment, while SIH is frequently treated with an epidural blood patch, which may require repeated procedures to achieve success. If CSF leakage cannot be improved, the concomitant CSDH may become organized. Therefore, it is important to thoroughly discuss the therapeutic options in individual cases.

Publication types

  • Case Reports
  • English Abstract

MeSH terms

  • Blood Patch, Epidural / adverse effects
  • Cerebrospinal Fluid Leak
  • Cerebrospinal Fluid Rhinorrhea / surgery
  • Craniotomy
  • Hematoma, Subdural, Chronic / complications*
  • Hematoma, Subdural, Chronic / diagnosis
  • Hematoma, Subdural, Chronic / therapy*
  • Humans
  • Intracranial Hypotension / complications*
  • Intracranial Hypotension / diagnosis
  • Intracranial Hypotension / therapy*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Reoperation
  • Time Factors
  • Tomography, X-Ray Computed
  • Treatment Outcome