Spontaneous Intracranial Hypotension

Background: Spontaneous intracranial hypotension (SIH) is a rare condition characterized by a cerebrospinal fluid (CSF) leak, leading to low CSF pressure within the skull. The exact etiology is not always clear, but potential contributing factors include connective tissue disorders, trauma, spinal procedures, and structural deformities. Early diagnosis and management based on presenting signs, symptoms, and timely investigations can prevent progression to more serious complications. Case Report: We present the case of a 39-year-old male with no known co-morbidities who reported a three-week history of postural headache. The headache worsened upon standing and improved when lying down. Lumbar puncture revealed an opening CSF pressure of 40 mm Hg. Cranial and spinal MRI showed pachymeningeal thickening, subdural effusion, and cerebellar tonsillar herniation. Conservative management, including bed rest, led to symptom resolution within two weeks. Conclusion: This case emphasizes the importance of recognizing the clinical features, diagnostic methods, and management options for SIH. Imaging and lumbar puncture were crucial for diagnosis, and conservative treatment effectively alleviated symptoms. This case contributes to the medical understanding and support for individuals affected by SIH.