Spontaneous intracranial hypotension in a patient without corpus callosum: A case report.

RATIONALE

Spontaneous intracranial hypotension (SIH) is a well-established condition typically presenting with disabling orthostatic headache. Corpus callosum agenesis (CCA) is one of the most common human brain malformations with a wide spectrum of associated malformations, chromosomal abnormalities, and clinical syndromes.

PATIENT CONCERNS

A 53-year-old woman presented with recurrent orthostatic headache for about 1 month. The head computed tomography examination of the patient showed CCA and the initial pressure of subsequent lumbar puncture was only 5 centimeters cerebrospinal fluid. Magnetic resonance imaging examination confirmed CCA with gray matter heterotopia.

DIAGNOSIS

The final diagnose was SIH related headache with CCA.

INTERVENTION

The patient's symptom improved after oral hydration, intravenous fluids, and bed rest.

OUTCOME

Favorable outcome was observed.

LESSONS

Although this co-occurrence of SIH and CCA is probably coincidental, this finding suggests that the developmental malformations of the brain may lead to structural changes in brain tissue or disturbances in cerebrospinal fluid production and reflux, resulting in pathological changes over time.