Neurological Deterioration Following Bilateral Burr-Hole Drainage for Chronic Subdural Hematoma: A Case Report| Stephy Publishers
SOJ Medical and Clinical Case Reports - (SOJMCCR) | Stephy Publishers Abstract Background: Spontaneous intracranial hypotension (SIH) is a relatively rare but known pathology that results in brain herniation or sagging due to CSF hypovolemia. SIH can commonly be misdiagnosed when occurring with other pathologies including chronic subdural hematoma (CSDH). Neurological decline caused by SIH is rare, but is often rapid and much more severe. Case description: A 69-year-old man was delivered to the emergency department for loss of consciousness and mild left hemiparesis. Brain computed tomography (CT) revealed increased density over basal cisterns suggestive of subarachnoid hemorrhage (SAH), and CSDH. Cerebral angiography showed dural arteriovenous fistula, but there was no apparent cerebral aneurysm. We first performed trans-arterial embolization using n-butyl cyanoacrylate, followed by bilateral hematoma evacuation. A postoperative CT showed that CSDH wa...