Coma from severe spontaneous intracranial hypotension due to a CSF-venous fistula.
Amin Yakubu, Joseph D Burns, Jonathan Pace et al.
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Case in brief
A patient presented in a coma due to severe spontaneous intracranial hypotension (SIH) caused by a spinal CSF-venous fistula. The condition led to significant brain sagging, compromising brainstem function. Multidisciplinary management was initiated, focusing on supportive care and rapid identification of the CSF leak, ultimately leading to recovery.
What made this case unusual
The case highlights a rare presentation of coma resulting from severe SIH due to a CSF-venous fistula, emphasizing the need for awareness of this potential complication.
Diagnostic / clinical pearl
Clinicians should consider spontaneous intracranial hypotension as a potential cause of coma, particularly in cases with unexplained neurological deterioration.
Why it matters
This case underscores the importance of a multidisciplinary approach in managing severe SIH, which can have critical implications for patient outcomes.