ArticleJournal of neurosurgery. Case lessons2023
Discovering spontaneous intracranial hypotension after failed middle meningeal artery embolization for subdural hematomas: illustrative cases.
Article in Journal of neurosurgery. Case lessons, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed, 2 citations in OpenAlex.
- Risk factors for subdural hematoma in spontaneous intracranial hypotension are male sex, longer disease duration, and repeated epidural blood patches.American journal of translational research · 2026Article
- Middle meningeal artery embolization as an alternative strategy for symptomatic CSF hypovolemia-related chronic subdural hematoma: A case series.Interventional neuroradiology : journal of peritherapeutic neuroradiology, surgical procedures and related neurosciences · 2025Article
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3 authors at 1 institution in 1 country.
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Abstract
backgroundSpontaneous intracranial hypotension (SIH) is a relatively rare and underdiagnosed disease. SIH can lead to subdural hematomas (SDHs) and other complications. SDHs secondary to SIH are difficult to manage, with no consensus in management, and SDHs commonly recur if underlying SIH is not treated. OBSERVATIONS: A 46-year-old male with vague sensory and orientation symptoms presented with bilateral SDHs, which were treated with middle meningeal artery (MMA) embolization and burr hole evacuation. The patient improved initially but had recurrent encephalopathy and SDHs. The patient received 3 epidural blood patches (EBPs) over 8 days with continued improvement. A 78-year-old female presented with headaches, and imaging revealed a left chronic SDH. She underwent MMA embolization and mini-craniotomy for SDH evacuation. Her symptoms returned and imaging revealed a recurrent SDH. Pan spine computed tomography myelography showed a high thoracic cerebrospinal fluid (CSF) leak. She underwent 3 EBPs over 8 days with neurological improvement and stabilization of her SDH. LESSONS: The authors show that, if SDH recurs after initial treatment with MMA embolization, then SIH should be strongly considered and treated with EBPs. Further investigation is required to determine the role of targeted or blind EBPs and the use of imaging to find the source of occult CSF leaks causing SIH.
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