title: Spontaneous Intracranial Hypotension: An Etiology for Consciousness Disorder and Coma.
abstract: We report 3 cases of spontaneous intracranial hypotension (SIH) associated with consciousness disorder and coma. In patients, SIH was suspected on a computed tomography scan and diagnosed by cerebral magnetic resonance imaging (MRI). Spinal MRI confirmed cerebrospinal fluid leakage. SIH should be seen as an underestimated cause of consciousness disorder and coma, especially in patients with a history of orthostatic headache, spinal injury, or oculomotor signs. Computed tomography scans should be examined for signs of SIH before operating on patients with a spontaneous subdural hematoma. Brain and spine MRI should be performed when SIH is suspected. Our 3 patients have shown good recovery without any neurological sequelae.
authors.affiliation: From the *Pôle Anesthésie Réanimation Chirurgicale, SAMU-SMUR, Hôpitaux Universitaires de Strasbourg, Strasbourg, France; †EA 3072, Institut de Physiologie, FMTS (Fédération de médecine translationnelle de Strasbourg), Faculté de Médecine de Strasbourg, Strasbourg, France; and ‡Service de Neurologie, §Service de Neurochirurgie, ‖Service de Médecine Interne et de Nutrition, ¶Service de Chirurgie Cardiovasculaire, and #Service de Radiologie 2, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Collange
authors.forename: Valérie
authors.initials: V
authors.lastname: Wolff
authors.forename: Hélène
authors.initials: H
authors.lastname: Cebula
authors.forename: Alain
authors.initials: A
authors.lastname: Pradignac
authors.forename: Alain
authors.initials: A
authors.lastname: Meyer
authors.forename: Michel
authors.initials: M
authors.lastname: Kindo
authors.forename: Pierre
authors.initials: P
authors.lastname: Diemunsch
authors.forename: François
authors.initials: F
authors.lastname: Proust
authors.forename: Paul-Michel
authors.initials: PM
authors.lastname: Mertes
authors.forename: Stéphane
authors.initials: S
authors.lastname: Kremer
mesh_terms: D065634:Cerebrospinal Fluid Leak / Q000150:complications* / Q000000981:diagnostic imaging; D003128:Coma / Q000000981:diagnostic imaging / Q000209:etiology*; D003244:Consciousness Disorders / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D019585:Intracranial Hypotension / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008875:Middle Aged