naa a22 4500 510799280 CHVBK 20180411083347.0 cr unu---uuuuu 180411e20130801xx s 000 0 eng 10.1007/s12028-012-9783-0 doi (NATIONALLICENCE)springer-10.1007/s12028-012-9783-0 Intrathecal Saline Infusion: An Emergency Procedure in a Patient with Spontaneous Intracranial Hypotension [Elektronische Daten] [Christian Sass, Christoph Kosinski, Patrick Schmidt, Michael Mull, Jörg Schulz, Johannes Schiefer] Background: Spontaneous intracranial hypotension (SIH) is a neurologic condition with the prototypical symptom of orthostatic headache. We report a dramatic case of SIH with life-threatening bilateral hygroma and uncal herniation. Methods: Case report. Results: A 44-year-old male patient presenting with orthostatic headache and double vision was diagnosed with SIH. Diagnostic imaging showed meningeal enhancement and bilateral hygroma. A conservative treatment regime was initiated. The patient's condition rapidly deteriorated with progressive loss of consciousness. Cranial MRI showed beginning uncal herniation. As an emergency treatment measure, an intracranial pressure (ICP) probe was inserted and intrathecal lumbal saline infusion was initiated. This led to a stabilization of ICP and allowed further diagnostics and treatment. Conclusion: Intrathecal lumbal saline infusion in combination with ICP monitoring can be a life-saving treatment option in unstable SIH patients. Springer Science+Business Media New York, 2012 Spontaneous intracranial hypotension nationallicence Subdural hygroma nationallicence Orthostatic coma nationallicence Csf leak nationallicence Low csf volume nationallicence Intrathecal saline infusion nationallicence Sass Christian Department of Neurology, University Hospital Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany aut Kosinski Christoph Department of Neurology, Medizinisches Zentrum StädteRegion Aachen, Würselen, Germany aut Schmidt Patrick Department of Neurology, Medizinisches Zentrum StädteRegion Aachen, Würselen, Germany aut Mull Michael Department of Neuroradiology, University Hospital Aachen, Aachen, Germany aut Schulz Jörg Department of Neurology, University Hospital Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany aut Schiefer Johannes Department of Neurology, University Hospital Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany aut Neurocritical Care Springer US; http://www.springer-ny.com 19/1(2013-08-01), 116-118 1541-6933 19:1<116 2013 19 12028 https://doi.org/10.1007/s12028-012-9783-0 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s12028-012-9783-0 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Sass Christian Department of Neurology, University Hospital Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany aut NATIONALLICENCE 700 1- Kosinski Christoph Department of Neurology, Medizinisches Zentrum StädteRegion Aachen, Würselen, Germany aut NATIONALLICENCE 700 1- Schmidt Patrick Department of Neurology, Medizinisches Zentrum StädteRegion Aachen, Würselen, Germany aut NATIONALLICENCE 700 1- Mull Michael Department of Neuroradiology, University Hospital Aachen, Aachen, Germany aut NATIONALLICENCE 700 1- Schulz Jörg Department of Neurology, University Hospital Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany aut NATIONALLICENCE 700 1- Schiefer Johannes Department of Neurology, University Hospital Aachen, Pauwelsstrasse 30, 52074, Aachen, Germany aut NATIONALLICENCE 773 0- Neurocritical Care Springer US; http://www.springer-ny.com 19/1(2013-08-01), 116-118 1541-6933 19:1<116 2013 19 12028 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer