Successful steroid treatment of coma induced by severe spontaneous intracranial hypotension.
Spontaneous intracranial hypotension (SIH) is a syndrome characterized by low cerebrospinal fluid (CSF) pressure and postural headaches. It is a rare condition which may sometimes present with severe symptoms such as stupor or coma. The standard treatment protocol includes conservative measures such as bed rest, hydration, and steroids. However, severe cases may require invasive measures such as epidural blood patch (EBP), continuous epidural saline infusion, epidural fibrin glue, or surgical repair of the dural defect. In this report, we describe a case of severe SIH resulting in coma that exhibited dramatic improvement on intravenous administration of steroids. This is the first report of severe SIH causing coma that was treated non-invasively by steroids only.
Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Japan.
Shunsaku
S
Goto
Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Japan.
Tomotaka
T
Ohshima
Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Japan.
Taiki
T
Yamamoto
Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Japan.
Shinji
S
Shimato
Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Japan.
Toshihisa
T
Nishizawa
Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Japan.
Kyozo
K
Kato
D000368:Aged; D017217:Blood Patch, Epidural; D003128:Coma; D004824:Epidural Space; D006261:Headache; D006801:Humans; D019585:Intracranial Hypotension; D008279:Magnetic Resonance Imaging; D008297:Male
coma; conservative treatment; spontaneous intracranial hypotension; steroids