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Spontaneous Intracranial Hypotension Presenting as Mental Deterioration

Authors

  • Ping-Huang Tsai MD,

  • Shuu-Jiun Wang MD,

  • Jiing-Feng Lirng MD,

  • Jong-Ling Fuh MD


  • From the Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan (Drs. Tsai, Wang, and Fuh); Department of Neurology, National Yang-Ming University School of Medicine, Taipei, Taiwan (Drs. Tsai, Wang, and Fuh); Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan (Dr. Lirng); and Department of Radiology, National Yang-Ming University School of Medicine, Taipei, Taiwan (Dr. Lirng).

Address all correspondence to Dr. Ling Fuh, The Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.

Abstract

A 55-year-old woman had new onset of postural headache followed by change of mental status 3 weeks later. Magnetic resonance imaging (MRI) of the brain and whole spine showed typical spontaneous intracranial hypotension (SIH) findings, bilateral subdural hematoma, and cerebrospinal fluid leakage over the T7–T9. Her headache and mentality improved after epidural blood patches. Early recognition and correct diagnosis are crucial for successful treatment in patients with SIH presenting with mental confusion.

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