Spontaneous intracranial hypotension (SIH) is considered to be a very rare disorder. It is characterized by an
orthostatic headache that is aggravated with the
patient in the upright position and it is relieved by the
patient assuming the
supine position. SIH is caused by a spontaneous spinal
cerebrospinal fluid leakage without the
patient having undergone
trauma,
surgery or dural
puncture or having any other significant medical
history. An autologous
epidural blood patch (EBP) is effective in relieving SIH. We
report here on a case of SIH with
cerebrospinal fluid leakage at the upper cervical vertebral level and the middle thoracic vertebral level. The points of
leakage were identified by
radionuclide cisternography, and this
patient was successfully managed by injecting an EBP at each level of
leakage.