Antypas Antony, Baker James, Koo Andrew
Radiology, Leeds Teaching Hospitals NHS Trust, Leeds, GBR.
Emergency Medicine, Bankstown-Lidcombe Hospital, Sydney, AUS.
Cureus. 2024 Oct 7;16(10):e71016. doi: 10.7759/cureus.71016. eCollection 2024 Oct.
Spontaneous intracranial hypotension (SIH) is a potentially debilitating condition caused by cerebrospinal fluid (CSF) leakage through dural tears, leaking meningeal diverticula, or CSF-venous fistulae. This case report describes two yoga-induced dural tears leading to spontaneous SIH. Diagnosing SIH due to dural tears and CSF leaks can be challenging, but magnetic resonance imaging (MRI) aids in confirmation. A woman in her 30s presented to the Emergency Department with a three-week history of sudden, right-sided orthostatic headache following a yoga session, accompanied by tinnitus, visual disturbances, and vomiting. A head and C-spine MRI, including a high-resolution constructive interference in steady state sequence, revealed pachymeningeal enhancement and dural tear at the C4/C5 interspinous process region. Despite conservative management and epidural blood patches, surgical intervention was required to treat the CSF leaks. This report underscores the importance of clinician awareness regarding yoga-associated SIH. Prompt diagnosis and accurate radiological assessment are crucial, and educating patients about the risks during yoga can aid in early detection and treatment.
自发性颅内低压（SIH）是一种潜在的使人衰弱的病症，由脑脊液（CSF）通过硬脑膜撕裂、渗漏的脑膜憩室或脑脊液-静脉瘘漏出引起。本病例报告描述了两例因瑜伽导致硬脑膜撕裂进而引发自发性SIH的情况。诊断由硬脑膜撕裂和脑脊液漏引起的SIH可能具有挑战性，但磁共振成像（MRI）有助于确诊。一名30多岁的女性因在一次瑜伽课程后出现右侧突发体位性头痛三周的病史，伴有耳鸣、视觉障碍和呕吐，就诊于急诊科。头部和颈椎MRI，包括高分辨率稳态构成干扰序列，显示在C4/C5棘突间区域有硬脑膜强化和硬脑膜撕裂。尽管进行了保守治疗和硬膜外血贴治疗，但仍需要手术干预来治疗脑脊液漏。本报告强调了临床医生对瑜伽相关性SIH的认识的重要性。及时诊断和准确的影像学评估至关重要，并且对患者进行瑜伽期间风险的教育有助于早期发现和治疗。
