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Atypical presentations and long-term sequelae of spontaneous intracranial hypotension: illustrative cases

Year: 2026

Type: article

Abstract: BACKGROUND: Spontaneous intracranial hypotension (SIH) is typically recognized by orthostatic headache and characteristic neuroimaging findings such as brain sagging and dural enhancement, but atypical manifestations and long-term sequelae remain underreported. OBSERVATIONS: The authors present 5 cases that illustrate uncommon SIH presentations and complications, including reversible cerebral vasoconstriction syndrome, sinus vein thrombosis, ventral spinal cord herniation, thoracic meningocele, secondary Arnold-Chiari malformation type I, and superficial siderosis. LESSONS: SIH may present with diverse complications beyond orthostatic headache; awareness and follow-up imaging are important for timely diagnosis and management. https://thejns.org/doi/10.3171/CASE26236.

Source: Journal of Neurosurgery Case Lessons

DOI: 10.3171/case26236

Authors: Danial Nasiri, Levin Häni, Alexis P. R. Terrapon, Katharina Lutz, Johannes Goldberg, Patrick Dorn, Christine Roten-Joss, Aude Eckert, Andreas Raabe, Werner J. Z’Graggen, Eike I. Piechowiak, Ralph T. Schär, Tomas Dobrocky

Institutions: University of Bern, University Hospital of Bern

Language: English

Topic: Neurosurgical Procedures and Complications

Subfield: Neurology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: hybrid

OpenAlex ID: W7172429481

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