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European Annals of Otorhinolaryngology, Head and Neck Diseases
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le vendredi 23 mars 2012
Doi : 10.1016/j.anorl.2011.08.005
A case of spontaneous intracranial hypotension: From Ménière-like syndrome to cerebral involvement
 

N. Fontaine ⁎ , A. Charpiot, C. Debry, A. Gentine
Service ORL, hôpital de Haute Pierre, 1, avenue Molière, 67100 Strasbourg, France 

Corresponding author.
Summary
Introduction

Spontaneous intracranial hypotension (SIH) is a rare pathology caused by unexplained and variably localized leakage of cerebrospinal fluid (CSF). The prime symptom is orthostatic headache, although other less specific clinical signs may predominate, and mislead diagnosis.

Case report

A 47-year-old man presented with Ménière-like symptoms of sudden onset. Secondary orthostatic headache led to the performance of cerebral MRI, which found signs suggestive of intracranial hypotension. A blood-patch was immediately carried out, and was followed by consciousness disorder associated with onset of bilateral subdural hematoma, which required iterative neurosurgical drainage. Myelo-CT confirmed CSF leakage facing the right 12th dorsal nerve root sheath. Radio-guided sealing with biologic glue provided complete regression of all symptoms.

Discussion/conclusion

Auditory signs may predominate in the clinical presentation of SIH. Their orthostatic character is suggestive. The present case is of a rare severe form. The role of neurosurgery in such cases remains to be defined.


Keywords : Spontaneous intracranial hypotension, Cerebrospinal fluid, Ménière-like, Orthostatic headache, Hydrops ex vacuo


OutlineMasquer le plan
Introduction
Case report
Discussion
Conclusion
Disclosure of interest


© 2012  Published by Elsevier Masson SAS.