This document presents a case study of a 44-year-old man diagnosed with spontaneous intracranial hypotension (SIH) secondary to cerebrospinal fluid leaks at C1-C3 and T6-T10. He presented with progressive headache, nausea, vomiting, and intermittent double vision. Imaging showed bilateral subdural hematomas and evidence of subarachnoid hemorrhage. He deteriorated with additional cranial nerve palsies until epidural blood patches were placed, which provided immediate relief and full recovery. SIH is often misdiagnosed but can be identified through characteristic symptoms, lumbar puncture findings and imaging evidence of CSF hypovolemia.

1. Case Presentation: Neurology/Neurosurgery Grand Rounds February 28, 2006 Gabriel Zada, MD Christopher Aho, MD Neurosurgery Blue LAC-USC Medical Center

6. Head CT

23. Brain MRI

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