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Brain Sci. 2016 Dec 29;7(1). pii: E3. doi: 10.3390/brainsci7010003.

An Unusual Case of Post-Traumatic Headache Complicated by Intracranial Hypotension.

Author information

1
Department of Neurology, Georgetown University Hospital, Washington, DC 20007, USA. ssiavosh@gmail.com.
2
Department of Neurology, Georgetown University Hospital, Washington, DC 20007, USA. Carrie.O.Dougherty@gunet.georgetown.edu.
3
Department of Neurology, Georgetown University Hospital, Washington, DC 20007, USA. Jessica.x.ailani@gunet.georgetown.edu.
4
Department of Neurology, Georgetown University Hospital, Washington, DC 20007, USA. Kyadwadk@gmail.com.
5
Department of Neurology, Georgetown University Hospital, Washington, DC 20007, USA. FXB10@gunet.georgetown.edu.

Abstract

We present a case of post-traumatic headache complicated by intracranial hypotension resulting in an acquired Chiari malformation and myelopathy with syringomyelia. This constellation of findings suggest a possible series of events that started with a traumatic cerebral spinal fluid (CSF) leak, followed by descent of the cerebellar tonsils and disruption of CSF circulation that caused spinal cord swelling and syrinx. This unusual presentation of post-traumatic headache highlights the varying presentations and the potential sequelae of intracranial hypotension. In addition, the delayed onset of upper motor neuron symptoms along with initially normal head computerized tomography scan (CT) findings, beg the question of whether or not a post-traumatic headache warrants earlier magnetic resonance imaging (MRI).

KEYWORDS:

cerebral spinal fluid leak; intracranial hypotension; post-traumatic headache; syringomyelia

Conflict of interest statement

Sara Siavoshi has no conflicts to report. Carrie Dougherty has received honoraria from Amgen. Jessica Ailani has received honoraria from Allergan, Teva, Avanir, Eli- Lily, and Current Pain and Headache reports. Kaustubh Yadwadkar and Frank Berkowitz have no conflicts to report.

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