Introduction: Spontaneous intracranial hypotension is an infrequent cause of secondary headache due to cerebrospinal fluid (CSF) hypovolemia.Objective: To describe a case of headache revealing spontaneous intracranial hypotension complicated by subdural hematoma following lumbar puncture.Observation: A 34-year-old man presented with acute postural headache. The first cerebral computed tomography scan was normal. Lumbar puncture showed hyperproteinorachy at 2 g/L with six lymphocytic cells. The headache became very intense. At admission, clinical examination was normal. Ophthalmological examination did not show any abnormalities. Encephalic magnetic resonance imaging (MRI) showed bilateral subdural hematoma with tonsillar descent simulating Chiari type I malformation. After surgical drainage and symptomatic treatment, the patient was discharged with no recurrence.Conclusion: Spontaneous intracranial hypotension is associated with simple clinical presentation, orthostatic headache, and characteristic MRI findings. Misdiagnosed, it leads to unnecessary procedures.
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机译：简介：自发性颅内低血压是由于脑脊液（CSF）低血容量引起的继发性头痛的罕见病因。目的：描述一例显示腰椎穿刺后自发性颅内低血压并发硬膜下血肿的头痛病例：一名34岁的男性。表现为急性姿势性头痛。第一次脑计算机断层扫描正常。腰穿显示6 g淋巴细胞具有2 g / L的高蛋白分泌。头痛变得非常剧烈。入院时，临床检查正常。眼科检查未发现任何异常。脑磁共振成像（MRI）显示双侧硬膜下血肿伴扁桃体下降，模拟了Chiari I型畸形。经过外科引流和对症治疗后，患者无出院。结论：自发性颅内低血压与简单的临床表现，体位性头痛和特征性MRI表现有关。误诊，将导致不必要的程序。
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