Bilateral subdural hematomas caused by spontaneous intracranial hypotension

Abstract

Patients with both spontaneous intracranial hypotension (SIH) and subdural hematomas (SDH) are frequently undiagnosed. SIH may recur very often over a short interval or result in disastrous consequences if only the SDH is dealt with. We report a young adult with severe posterior nuchal pain; brain computed tomography showed bilateral SDH. He was discharged smoothly without any neurologic deficit after epidural blood patches were applied after proper and timely diagnosis. Patients with SIH complicated by SDH should not be overlooked. When patients complain of typical orthostatic headache without any history of trauma, SIH should be highly suspected. The therapeutic strategy for this type of SDH is different from those without SIH. We review the literature on the disease.