Spontaneous intracranial hypotension associated with cerebral venous thrombosis detected by a sudden seizure: a case report

Abstract

Background: Spontaneous intracranial hypotension (SIH) is rare but can lead to life-threatening complications including cerebral venous thrombosis (CVT). The concurrence of CVT and SIH raises questions regarding priority. Case presentation: We present the case of a 52-year-old woman who developed sudden left-sided hemiparesis and generalized tonic-clonic seizures. She experienced progressive orthostatic headaches over the prior 2 weeks. Imaging showed thrombosis in the left transverse and sigmoid sinuses, bilateral subdural hematomas, and a cervicothoracic cerebrospinal fluid leak. Low molecular weight heparin was administered, but it was discontinued 2 days later due to subarachnoid hemorrhage. She was transferred to our hospital where an epidural blood patch was applied immediately, which resulted in complete symptom relief. Conclusion: CVT is a rare complication of SIH that may result in devastating consequences. Treatment of SIH should be the primary focus. Prompt diagnosis and EBP application can result in a good outcome.

Spontaneous Intracranial Hypotension Discovered Following Cerebral Venous Thrombosis: A Case Report and Review of the Literature

“…Isolated cortical vein thrombosis is an even rarer complication at 0.4% [5]. We identified 53 previously reported cases, including the present case [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18]. Among these 53 cases, thrombosis involving the cerebral venous sinuses was observed in 38 (71.7%) and isolated cortical vein thrombosis was observed in 15 (28.3%).…”

Superior Sagittal Sinus Thrombosis in a Patient With Iatrogenic Intracranial Hypotension: A Case Report

“…Many reports have described the association between CVST and intracranial hypotension, whether spontaneous or induced by durotomy secondary to lumbar punctures, spinal and epidural anesthesia, and myelography [6][7][8][9][10][11][12][13]. However, only one case has been reported where CVST developed following spinal surgery [2].…”

Cerebral venous thrombosis following spontaneous intracranial hypotension diagnosed by craniotomy: A case report and diagnostic pitfalls

“…Moreover, seizures are quite common as the first symptom of CVT onset. According to past literature in which 42 case reports were reviewed,[ 14 ] 31 patients (73.8%) developed orthostatic headache, but 11 patients (26.2%) developed headache without orthostatic change. Furthermore, 12 patients (28.6%) had a seizure attack, as seen in our case.…”