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Intracranial hypotension secondary to spinal arachnoid cyst rupture presenting with acute severe headache: a case report

By: Contributor(s): Publication details: 2010Uniform titles:
  • Journal of Medical Case Reports
Online resources: Summary: <h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">INTRODUCTION:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">Headache is a common presenting complaint and has a wide differential diagnosis. Clinicians need to be alert to clues that may suggest an underlying secondary aetiology. We describe a novel case of headache secondary to intracranial hypotension which was precipitated by the rupture of a spinal arachnoid cyst.</span></p><h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">CASE REPORT:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">A 51-year-old Indian female presented with sudden onset severe headache suggestive of a subarachnoid haemorrage. Investigations including a computed tomography brain scan, cerebrospinal fluid examination and a magnetic resonance angiogram were normal. The headache persisted and magnetic resonance imaging revealed bilateral thin subdural collections, a spinal subarachnoid cyst and a right-sided pleural effusion. This was consistent with a diagnosis of headache secondary to intracranial hypotension resulting from spinal arachnoid cyst rupture.</span></p><h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">CONCLUSIONS:</span></h4><p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"><span style="font-size: 10pt;">Spinal arachnoid cyst rupture is a rare cause of spontaneous intracranial hypotension. Spontaneous intracranial hypotension is a common yet under-diagnosed heterogeneous condition. It should feature significantly in the differential diagnosis of patients with new-onset daily persistent headache.</span></p>
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UNKNOWN Ferriman information and Library Service (North Middlesex) Online Staff publications for NMDX Available

NMUH Staff Publications

17

&lt;h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"&gt;&lt;span style="font-size: 10pt;"&gt;INTRODUCTION:&lt;/span&gt;&lt;/h4&gt;&lt;p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"&gt;&lt;span style="font-size: 10pt;"&gt;Headache is a common presenting complaint and has a wide differential diagnosis. Clinicians need to be alert to clues that may suggest an underlying secondary aetiology. We describe a novel case of headache secondary to intracranial hypotension which was precipitated by the rupture of a spinal arachnoid cyst.&lt;/span&gt;&lt;/p&gt;&lt;h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"&gt;&lt;span style="font-size: 10pt;"&gt;CASE REPORT:&lt;/span&gt;&lt;/h4&gt;&lt;p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"&gt;&lt;span style="font-size: 10pt;"&gt;A 51-year-old Indian female presented with sudden onset severe headache suggestive of a subarachnoid haemorrage. Investigations including a computed tomography brain scan, cerebrospinal fluid examination and a magnetic resonance angiogram were normal. The headache persisted and magnetic resonance imaging revealed bilateral thin subdural collections, a spinal subarachnoid cyst and a right-sided pleural effusion. This was consistent with a diagnosis of headache secondary to intracranial hypotension resulting from spinal arachnoid cyst rupture.&lt;/span&gt;&lt;/p&gt;&lt;h4 style="font-size: 13px; margin: 0px 0.25em 0px 0px; text-transform: uppercase; float: left; font-family: arial, helvetica, clean, sans-serif;"&gt;&lt;span style="font-size: 10pt;"&gt;CONCLUSIONS:&lt;/span&gt;&lt;/h4&gt;&lt;p style="margin: 0px 0px 0.5em; line-height: 1.538em; font-size: 1.04em; font-family: arial, helvetica, clean, sans-serif;"&gt;&lt;span style="font-size: 10pt;"&gt;Spinal arachnoid cyst rupture is a rare cause of spontaneous intracranial hypotension. Spontaneous intracranial hypotension is a common yet under-diagnosed heterogeneous condition. It should feature significantly in the differential diagnosis of patients with new-onset daily persistent headache.&lt;/span&gt;&lt;/p&gt;

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