Cervical Osteophyte as a Rare Etiology of Spontaneous Intracranial Hypotension With Bilateral Subdural Hematomas: A Case Report and Literature Review

Spontaneous intracranial hypotension (SIH) is a clinical syndrome typically resulting from occult cerebrospinal fluid (CSF) leaks, though a cervical bone spur as the primary etiology is an exceptionally rare occurrence. This report describes a 41-year-old male patient who presented with a two-month history of persistent headaches, dizziness, and an acute confusional state. Initial imaging revealed bilateral subdural hematomas, while subsequent magnetic resonance imaging (MRI) of the brain and spine identified diffuse meningeal enhancement and a type 1 meningeal breach at the C7-T1 level caused by a focal osteophyte. The patient underwent a successful two-stage surgical intervention involving an anterior cervical discectomy and fusion (ACDF) to repair the dural defect, followed by the evacuation of the hematomas. Post-operative recovery was uneventful, with a six-month follow-up confirming the complete resolution of intracranial abnormalities and a full return to functional baseline. This case emphasizes that SIH should remain a diagnostic consideration in patients with persistent headaches and underscores the importance of identifying mechanical spinal triggers, such as osteophytes, to ensure definitive surgical repair and optimal neurological outcomes.