Journal of the Chinese Medical Association
Volume 71, Issue 3 , Pages 147-151, March 2008

Bilateral Subdural Hematomas Caused by Spontaneous Intracranial Hypotension

  • Hsin-Hung Chen

      Affiliations

    • Department of Neurosurgery, The Neurological Institute, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • Corresponding Author InformationCorrespondence to: Dr Hsin-Hung Chen, Department of Neurosurgery, The Neurological Institute, Taipei Veterans General Hospital, 201, Section 2, Shih-Pai Road, Taipei 112, Taiwan, R.O.C.
    • ,
  • Chun-I Huang

      Affiliations

    • Department of Neurosurgery, The Neurological Institute, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Shu-Shya Hseu

      Affiliations

    • Department of Anesthesiology, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.
    • ,
  • Jiing-Feng Lirng

      Affiliations

    • Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, R.O.C.
    • National Yang-Ming University School of Medicine, Taipei, Taiwan, R.O.C.

Received 29 June 2007; accepted 17 September 2007.

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.

Key Words:  intracranial hypotension , orthostatic headache , subdural hematoma , surgical intervention

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PII: S1726-4901(08)70007-8

doi:10.1016/S1726-4901(08)70007-8

Journal of the Chinese Medical Association
Volume 71, Issue 3 , Pages 147-151, March 2008

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