Spontaneous intracranial hypotension resulting in stupor caused by diencephalic compression.
A 51-year-old man had a 4-month history of progressive headache and gradual onset of somnolence. MRI suggested spontaneous intracranial hypotension (SIH) with diencephalic compression, but he did not improve after three epidural blood patches. He became alert following intrathecal saline infusion that normalized his CSF pressure. A CSF leak was noted on spinal MRI and confirmed with CT contrast myelography. Surgical ligation of a torn dural root sleeve isolating a ruptured Tarlov's cyst resulted in permanent cure.
Pleasure
S J
SJ
Department of Neurology, University of California, San Francisco School of Medicine, USA.
Abosch
A
A
Friedman
J
J
Ko
N U
NU
Barbaro
N
N
Dillon
W
W
Fishman
R A
RA
Poncelet
A N
AN
D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D002555:Cerebrospinal Fluid / Q000502:physiology; D003560:Cysts / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D004027:Diencephalon / Q000503:physiopathology*; D006801:Humans; D019585:Intracranial Hypotension / Q000175:diagnosis / Q000209:etiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010523:Peripheral Nervous System Diseases / Q000150:complications / Q000503:physiopathology / Q000601:surgery; D011312:Pressure; D012422:Rupture, Spontaneous; D012894:Sleep Stages / Q000502:physiology*; D013126:Spinal Nerve Roots; D014057:Tomography, X-Ray Computed