Presentation
Mild headache and neck stiffness with recent history of cesarean section
Patient Data
Thin layer of bilateral subdural effusion which follows CSF signal on all sequences. Mild diffuse dural thickening with enhancement. Superior sagittal sinus is enlarged and rounded. Pituitary gland appears mildly enlarged. No evidence of tonsillar ectopia.
Case Discussion
The patient in this case was a young woman who presented with headache and neck stiffness after cesarean section delivery. Since meningitis was suspected, brain MRI was done. Taking both the physical examination and imaging findings into account, intracranial hypotension was the top differential diagnosis.
To ascertain the putative diagnosis of intracranial hypotension, the opening pressure on lumbar puncture should be less than 7 cm H2O.
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