Successful Treatment of Spontaneous Intracranial Hypotension With Subdural Hematoma With Cervical Epidural Blood Patch: A Case Report.

Spontaneous intracranial hypotension (SIH) is characterized by orthostatic headache. In severe cases, SIH can be complicated by symptomatic subdural hematoma. There is a lack of consistency and established treatment guidelines for the management of SIH. Lumbar epidural patch is the recommended first-line invasive treatment after failing conservative management. We present the case of a 42-year-old man with SIH complicated by symptomatic left subdural hematoma, which was successfully treated with surgical drainages and targeted cervical epidural blood patch. The primary aim of management of SIH is to stop cerebrospinal fluid leakage, and if the necessary specialty is available, targeted cervical epidural blood patch may be proposed as first-line invasive treatment. Symptomatic subdural hematoma should be managed with prompt action such as surgical drainage or middle meningeal artery embolization.