SPONTANEOUS INTRACRANIAL HYPOTENSION RESULTING IN STUPOR CAUSED BY DIENCEPHALIC COMPRESSION

A 51-year-old man had a 4-month history of progressive headache and gr adual onset of somnolence. MRI suggested spontaneous intracranial hypo tension (SIH) with diencephalic compression, but he did not improve af ter three epidural blood patches. He became alert following intratheca l saline infusion that normalized his CSF pressure. A CSF leak was not ed on spinal MRI and confirmed with CT contrast myelography. Surgical ligation of a torn dural root sleeve isolating a ruptured Tarlov's cys t resulted in permanent cure.