A fatal case of spontaneous intracranial hypotension with bilateral chronic subdural hematoma

Abstract

Spontaneous intracranial hypotension (SIH) can present with a variety of clinical symptoms. a few cases presented with disturbances of consciousness. A fatal case of SIH with bilateral chronic subdural hematom (CSDH), who presented with severe headache and unconsciousness, is described. A 50-year-old man who had been suffering from headache for about one month was admitted unconscious to our hospital. The patient’s level of consciousness improved after bilateral burr-hole irrigation therapy. However, three days after irrigation therapy, the patient’s consciousness level deteriorated. One week following admission, an epidural blood patch (EBP) was performed, but his consciousness level deteriorated further. After serial EBPs, his consciousness level failed to improve, and he died 17 days after admission. SIH is generally considered to have a benign prognosis, but when patients have an associated disturbance of consciousness, they should be rapidly and appropriately treated.