Etiological analysis and treatment of spontaneous intracranial hypotension with cerebral venous sinus thrombosis: one case report

Objective According to the diagnosis and treatment process of a case of spontaneous intracranial hypotension (SIH) with cerebral venous sinus thrombosis (CVST), the etiology, diagnosis and treatment were analyzed in order to improve the clinicians' understanding. Methods and Results A 34⁃year⁃old male patient developed persistent headache in the occipital region accompanied by intermittent throb⁃like pain. The onset was independent of body position or circadian rhythm, and the symptoms were progressively aggravated. The patient was initially diagnosed with CVST, and gained a poor curative effect of endovascular treatment and anticoagulant therapy. The subsequent diagnosis of SIH with CVST was corrected by head MRI and magnetic resonance myelography (MRM). After bedrest, hydration, steroids, anticoagulation and defibration therapy, the headache symptoms disappeared and the laboratory test results returned to the normal range. There was no recurrence after discharge. Conclusions For CVST patients without typical orthostatic headache, more attentions should be paid to the analysis of imaging findings and clinical data, in order to avoid the possibility of missed diagnosis of intracranial hypotension syndrome (IHS).