Bilateral Subdural Hematomas Caused by …

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J Chin Med Assoc March 2008 Vol 71 No 3147IntroductionSpontaneous intracranial hypotension (SIH) is causedby spontaneous cerebral spinal fluid (CSF) leakage ofunknown etiology at the level of the spine. Patientspresent with a new headache that occurs shortly afterassuming an upright position and is relieved by lyingdown (orthostatic headache). Although such a posi-tional headache pattern is well-known following a lum-bar puncture, SIH is not well recognized, and thepatient may be diagnosed with migraine, tensionheadache, viral meningitis, or malingering. The spon-taneous form of intracranial hypotension was firstdescribed in 1938, and much has been learned aboutthis syndrome, particularly since the early 1990s, butfrequent initial misdiagnosis SIH among physicians in general and the unusuallyvaried spectrum of clinical and radiographic manifes-tations may all contribute to a delay in diagno

J Chin Med Assoc • March 2008 • Vol 71 • No 3 147 Introduction Spontaneous intracranial hypotension (SIH) is caused by spontaneous cerebral spinal fluid (CSF) leakage of unknown etiology at the level of the spine.

  Subdural, Intracranial