Intracranial hypotension presenting with severe encephalopathy

Case report

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  • 1 Departments of Neurosurgery and Neurology, and Division of Pulmonary and Critical Care Medicine, Stanford University School of Medicine, Stanford, California
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✓ A patient with severe and protracted symptoms from intracranial hypotension is described. The patient's presentation was marked by diffuse encephalopathy and profound depression of consciousness. This case report expands the presently known clinical spectrum of this uncommon and generally benign illness. The clinical and laboratory findings typically observed in the syndrome of intracranial hypotension are outlined. The pathophysiological mechanisms of the phenomenon are briefly discussed. Intracranial hypotension is a potentially severe illness with specific treatments that are distinct from the treatment of most neurological diseases. Three cardinal features—postural headache, pachymeningitis, and descent of midline cerebral structures—should prompt the diagnosis.

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Contributor Notes

Address reprint requests to: Carter E. Beck, M.D., Department of Neurosurgery, MC: 5327, Stanford University Medical Center, 300 Pasteur Drive, Stanford, California 94305.
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