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• Vol.46 No.6
• CLINICA NEUROL, 46: 395−399, 2006
• Vol.46 No.6 contents

Case Report

A case of intracranial hypotension responsive to oral prednisolone

Kenichi Sakajiri, M.D., Michiyo Ohtaki, M.D., Tomofumi Yoshinaga, M.D. and Shinji Uchiyama, M.D.

Ishikawa Prefectural Central Hospital, Department of Neurology

A 31-year-old female patient with headache and nausea was admitted to our hospital, although there were no apparent neurological abnormalities except headache. Cerebrospinal fluid (CSF) pressure was 40 mmH₂O on the first lumbar puncture and CT showed some fluid in the left maxillary sinus. She gradually developed orthostatic headache despite antibiotics, hydration and analgesics. MRI showed diffuse meningeal thickening and enhancement. CSF pressure was 0 mmH₂O on the second lumbar puncture and RI cisternography demonstrated early excretion to the kidneys. She was diagnosed with intracranial hypotension due to CSF leakage. An autologous 10 ml blood patch on the lumbar epidural space did not relieve the orthostatic headache. However, headache disappeared one day after oral intake of 40 mg prednisolone. During the next three months, oral prednisolone was tapered off. Three months after the onset of the illness, MRI did not show either meningeal thickening or enhancement. We concluded that oral prednisolone was effective in a case of intracranial hypotension.

(CLINICA NEUROL, 46: 395−399, 2006)
key words: headache, intracranial hypotension, steroid, MRI, RI cisternography

(Received: 27-Nov-05)