Open AccessSpontaneous Low Cerebrospinal Fluid Pressure Headache Initially Misdiagnosed as a Tension‐type Headache
Author(s) -
Nishisako Hisashi,
Kunishima Hiroyuki,
Shimizu Gohji,
Naitou Yoshiyuki,
Teruya Yoko,
Yokokawa Masatoshi,
Masui Kentaro,
Hirose Masanori,
Sakai Tsubasa,
Yamasaki Yukitaka,
Tsuchida Tomoya,
Nemoto Takaaki,
Torikai Keito,
Nakagawa Teisuke,
Matsuda Takahide
Publication year - 2014
Publication title -
general medicine
Language(s) - English
Resource type - Journals
eISSN - 1883-6011
pISSN - 1346-0072
DOI - 10.14442/general.15.43
Subject(s) - medicine , nausea , cerebrospinal fluid pressure , cerebrospinal fluid , intracranial hypotension , hematoma , magnetic resonance imaging , supine position , anesthesia , complication , vomiting , intracranial pressure , surgery , radiology , pathology
We report the case of a 34‐year‐old man who was initially diagnosed with a tension‐type headache after complaining of a headache and nausea. His headache worsened in severity and it was exacerbated on standing in the upright position. The patient was admitted to the hospital on suspicion of spontaneous low cerebrospinal fluid (CSF) pressure headache. Gadolinium‐enhanced brain magnetic resonance imaging (MRI) revealed diffuse pachymeningeal enhancement, brain sagging, cerebellar tonsillar herniation, brainstem descent and a subdural hematoma. Successful emergency surgery was undertaken. Spontaneous low CSF pressure headache syndrome is characterized by orthostatic headache, and if such a headache worsens, clinicians should consider a subdural hematoma, a life‐threatening complication of this unusual disorder.