An Unusual Case of Post-Traumatic Headache Complicated by Intracranial Hypotension

• Main Authors: Sara Siavoshi, Carrie Dougherty, Jessica Ailani, Kaustubh Yadwadkar, Frank Berkowitz
• Format: Article
• Language: English
• Published: MDPI AG 2016-12-01
• Series: Brain Sciences
• Subjects: post-traumatic headache; intracranial hypotension; syringomyelia; cerebral spinal fluid leak
• Online Access: http://www.mdpi.com/2076-3425/7/1/3

We present a case of post-traumatic headache complicated by intracranial hypotension resulting in an acquired Chiari malformation and myelopathy with syringomyelia. This constellation of findings suggest a possible series of events that started with a traumatic cerebral spinal fluid (CSF) leak, followed by descent of the cerebellar tonsils and disruption of CSF circulation that caused spinal cord swelling and syrinx. This unusual presentation of post-traumatic headache highlights the varying presentations and the potential sequelae of intracranial hypotension. In addition, the delayed onset of upper motor neuron symptoms along with initially normal head computerized tomography scan (CT) findings, beg the question of whether or not a post-traumatic headache warrants earlier magnetic resonance imaging (MRI).