Abstract
We report a rare case of spontaneous intracranial hypotension accompanying thrombosis of the cerebral cortical veins and the superior sagittal sinus. A 43-year-old female who had suffered from orthostatic headache was admitted to a local hospital under the diagnosis of intracranial hypotension. At 15 days after onset, the headache had worsened and was combined with epileptic seizures, in spite of the patient being restricted to bed rest and the administration of intravenous hydration. Magnetic resonance (MR) imaging and cerebral angiography taken in our institute on day 22 revealed a thrombosis of the superior sagittal sinus and the adjacent cortical veins. Radionuclide cisternography demonstrated a cerebrospinal fluid leak at the lower thoracic spine. After anticoagulation therapy was administered followed by an epidural blood patch, the patient recovered with no neurological deficits. Intracranial hypotension accompanying cerebral venous thrombosis is very rare ; however, we should be aware of this complication and alert to its possible manifestation, especially when patients show changes in their headache features and symptoms even when observing a regime of strict bed rest.
