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Spontaneous intracranial hypotension due to a spinal CSF leak can cause new headaches in young and middle-aged adults.1 Typically, patients present with orthostatic headaches, but other symptoms have been reported, including neck pain, diplopia, hearing abnormalities, parkinsonism, dementia, and coma.1 We report a patient with spontaneous intracranial hypotension who presented with acute quadriplegia.
Case report.
A 54-year-old woman reached backward while sitting in a parked car and suddenly experienced a sensation of “pins and needles” in her head and noticed that she was unable to move her arms and legs. After approximately 30 to 40 seconds, she rapidly regained full strength in her extremities. In the emergency department, a head CT was interpreted as normal, a diagnosis of stroke was made, and aspirin was administered. Approximately 2 hours after the ictus, she noticed pain in the posterior neck and head, which was relieved by the upright position and worsened within minutes of lying down. Two weeks later, MRIs were obtained, and these were interpreted as showing a Chiari malformation and “posttraumatic” changes in …
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