ABSTRACT

Spontaneous intracranial hypotension (SIH) is a syndrome causing orthostatic headaches due to spontaneous spinal cerebrospinal fl uid (CSF) leak. The patients present with postural headache, tinnitus, vertigo, diplopia, facial hypoesthesia, and complaints of nausea and vomiting. The diagnosis is performed by anamnesis, clinic and radiological investigations. The treatment is conservative therapy or early epidural blood patches. A 32 year old man presented at our emergency department with a headache which had begun from his neck and upper back when he awoke in the morning 15 days earlier. The headache was increasied while he stood up, and decreased while he lay down. He had diplopia for the previous two days. A diagnosis of Spontaneous Intracranial Hypotension Syndrome was made due to his postural type headache, cranial MRI and radioactive cisternography fi ndings. We have attempted to emphasize theimportance of the approach a case with spontaneous intracranial hypotension syndrome, which is seen rarely, and generally misdiagnosed.

Keywords: Spontaneous intracranial hypotension, diplopia, orthostatic headache, conservative treatment