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Rehabilitation Practice and Science

Translated Title

自發性顱內低壓伴隨多處腦部缺血性中風：病例報告

Abstract

The causes of cerebrospinal fluid leakage leading to intracranial hypotension are generally iatrogenic or due to trauma. Postural headache is usually a characteristic symptom of intracranial hypotension, although other presenting neurologic symptoms occur, such as cranial nerve injury, vomiting, dizziness, photophobia, ataxia, dementia, coma, or death. A spontaneous cause for intracranial hypotension is uncommon. Intracranial hypotension with ischemic stroke, as described herein, has not been previously reported.A 43-year-old man complained of intermittent headaches for approximately one year, but the symptoms remitted with bedrest. He was ultimately sent to the hospital due to a severe headache. Although there were no significant findings on physical examination, a CT of the head revealed bilateral subdural hemorrhage and myelography indicated CSF leakage. Because the patient did not report to have a history of trauma, a diagnosis of spontaneous intracranial hypotension was made. An emergent subdural blood patch was placed and the hematoma was evacuated due to progressive changes in consciousness. Three days after surgery, multiple infarctions were confirmed by cranial CT. Even though the patient recovered consciousness, complications of ischemic stroke included bilateral blindness, limitation of extraocular muscle movement, ptosis, and poor functional status. The rehabilitation program was difficult due to the risk of recurrent attacks during exercise. In addition to share our clinical experience, the current case illustrates the need for additional research in CSF leakage and intracranial hypotension.

Language

Traditional Chinese

First Page

255

Last Page

260

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