title: Intracranial hypotension after trauma.
abstract: BACKGROUND
  Intracranial hypotension (IH) occurs typically spontaneous and is a potentially life-threatening condition characterized by symptoms varying from postural headache to coma, with classical magnetic resonance imaging (MRI) findings.
  
  
  METHODS
  We report two cases of clinically relevant trauma-related IH and review of the literature. One patient with a cerebral trauma presented unilateral mydriasis and coma resolved by the Trendelenburg position (-20°) as urgency intervention. In the second patient, IH was caused by a lesion of the brachial plexus after a motor vehicle accident.
  
  
  CONCLUSIONS
  A history of mild or moderate trauma in association with prolonged postural or permanent headache may indicate IH. Posttraumatic IH is rare, nevertheless life-threatening in case of misdiagnosis. Intracranial hypotension in a trauma context is rarely described and difficult to diagnose. The change from tipical supine 30° to Trendelenburg position (0-20°) can be a life-saving manoeuver in these patients.
authors.affiliation: Division of Neurosurgery, Department of Clinical Neurosciences, Faculty of Medicine, Geneva University Medical Center, Geneva, Switzerland.
authors.forename: Asita S
authors.initials: AS
authors.lastname: Sarrafzadeh
authors.affiliation: Division of Neurosurgery, Department of Clinical Neurosciences, Faculty of Medicine, Geneva University Medical Center, Geneva, Switzerland.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Hopf
authors.affiliation: Division of Neurosurgery, Department of Clinical Neurosciences, Faculty of Medicine, Geneva University Medical Center, Geneva, Switzerland.
authors.forename: Oliver P
authors.initials: OP
authors.lastname: Gautschi
authors.affiliation: Department of Interventional and Diagnostic Neuroradiology, University Hospital of Geneva, Geneva, Switzerland.
authors.forename: Ana-Paula
authors.initials: AP
authors.lastname: Narata
authors.affiliation: Division of Neurosurgery, Department of Clinical Neurosciences, Faculty of Medicine, Geneva University Medical Center, Geneva, Switzerland.
authors.forename: Karl
authors.initials: K
authors.lastname: Schaller
keywords: Chronic subdural hematoma; Intracranial hypotension; TBI