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A A Case Rep. 2016 Nov 15;7(10):207-211.

Spontaneous Intracranial Hypotension: An Etiology for Consciousness Disorder and Coma.

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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.


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.

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