A Rare Case of Spontaneous Intracranial Hypotension Secondary to C4-C5 and T12 Dural Tears Following a Yoga Class.

Antypas, A.; Baker, J.; Koo, A.

A Rare Case of Spontaneous Intracranial Hypotension Secondary to C4-C5 and T12 Dural Tears Following a Yoga Class.

All Authors

Antypas, A.

Baker, J.

Koo, A.

LTHT Author

Antypas, Antony

LTHT Department

Radiology

Publication Date

2024

Item Type

Case Reports
Journal Article

Abstract

Spontaneous intracranial hypotension (SIH) is a potentially debilitating condition caused by cerebrospinal fluid (CSF) leakage through dural tears, leaking meningeal diverticula, or CSF-venous fistulae. This case report describes two yoga-induced dural tears leading to spontaneous SIH. Diagnosing SIH due to dural tears and CSF leaks can be challenging, but magnetic resonance imaging (MRI) aids in confirmation. A woman in her 30s presented to the Emergency Department with a three-week history of sudden, right-sided orthostatic headache following a yoga session, accompanied by tinnitus, visual disturbances, and vomiting. A head and C-spine MRI, including a high-resolution constructive interference in steady state sequence, revealed pachymeningeal enhancement and dural tear at the C4/C5 interspinous process region. Despite conservative management and epidural blood patches, surgical intervention was required to treat the CSF leaks. This report underscores the importance of clinician awareness regarding yoga-associated SIH. Prompt diagnosis and accurate radiological assessment are crucial, and educating patients about the risks during yoga can aid in early detection and treatment.