[Spontaneous intracranial hypotension syndrome: two case reports].

INTRODUCTION. Spontaneous intracranial hypotension is caused by spontaneous spinal cerebrospinal fluid leaks and is known for causing orthostatic headaches, and a wide variety of associated symptoms have been reported. CASE REPORTS. We described two cases with spontaneous intracranial hypotension, treated in a short period of time, who presented with orthostatic headache and the neuroimaging studies showed subdural collections. Both patients were diagnosed of spinal cerebrospinal fluid leaks and treated with blood patches. CONCLUSIONS. Although intracranial hypotension is not an uncommon pathology, it usually presents diagnostic problems due to the diversity of symptoms that can occur. MRI is essential for the diagnosis by showing enhancement of the pachymeninges following administration of gadolinium and to prove the cerebrospinal fluid leak are useful spinal MRI, the computerized tomography myelography and the radionuclide cisternography. If conservative treatment falls, the epidural blood patch is the initial treatment of choice, reserving surgery for patients with persistent symptoms.