Repeated Deterioration of Consciousness Resulting from Spontaneous Intracranial Hypotension Associated with Deep Cerebral Vein Stagnation

Haruto Uchino*, Saori Hamada, Daina Kashiwazaki, Takahiro Tomita, Naoki Akioka, Takuya Akai, Satoshi Kuroda

*この論文の責任著者

研究成果: ジャーナルへの寄稿学術論文査読

5 被引用数 (Scopus)

抄録

Background: Although the clinical course of spontaneous intracranial hypotension (SIH) is generally benign, in unusual cases it can result in deterioration of consciousness. The exact mechanisms involved have not always been described in previously reported cases. Case Description: Herein we describe the case of a 36-year-old man who presented complaining of orthostatic headache. Brain magnetic resonance imaging depicted typical findings associated with SIH. He initially underwent conservative treatments, but he subsequently began to exhibit deterioration of consciousness. Magnetic resonance imaging revealed progressive brain sagging, swelling of the brainstem, and focal hyperintensity in the left side of the thalamus on diffusion-weighted imaging. The vein of Galen was stretched downwards, creating a narrow angle between it and the straight sinus. We concluded that deep venous hypertension had occurred due to functional venous stenosis. He underwent epidural blood patch twice and ultimately recovered without any neurologic deficits. Conclusions: SIH should be recognized as a possible cause of coma as a result of deep cerebral vein stagnation due to severe brain sagging. A change in the vein of Galen/straight sinus angle may be an anatomic marker associated with functional venous stenosis.

本文言語英語
ページ(範囲)371-374
ページ数4
ジャーナルWorld Neurosurgery
132
DOI
出版ステータス出版済み - 2019/12

ASJC Scopus 主題領域

  • 外科
  • 臨床神経学

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