A patient with superficial siderosis, intraspinal cyst, low-pressure headache and low-lying cord.

Superficial siderosis is a rare condition caused by deposition of hemosiderin in the central nervous system. In recent years, it has been used to identify dural defects connecting the intrathecal space with the intraspinal fluid-filled collection seen in patients with superficial siderosis. However rare reports describe the association of low-lying cord in superficial siderosis patients. We present a patient with progressive cerebellar ataxia, sensorineural hearing loss, low-pressure headache, pyramidal signs and additional cervical and lumbar radiculopathy with neurogenic bladder which might be related to cervical disc herniation and tethered cord. CSF and Magnetic resonance imaging (MRI) studies confirmed the diagnosis of superficial siderosis. Dural defect is indirectly suspected by existence of fluid-filled collection ventral to the spinal cord and low-pressure headache in our patient. Underlying causes of low-pressure headache and possible dural defect should be searched for as an associated and possibly treatable condition in superficial siderosis and provide further insights into the mechanism of bleeding in our patient who have an intraspinal fluid-filled collection.