{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:23:23Z","timestamp":1789014203183,"version":"build-2803163510"},"reference-count":80,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"<jats:sec id=\"st1\">\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Spontaneous intracranial hypotension (SIH) is a well-recognized but often underdiagnosed cause of secondary subdural hematoma (SDH), particularly in younger patients who frequently present with bilateral collections. The role of lumbar puncture (LP) remains controversial in this setting, as additional cerebrospinal fluid removal may destabilize intracranial pressure and precipitate or worsen SDH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st2\">\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>We performed a systematic review of SIH cases associated with bilateral SDH. When possible, we reconstructed a patient-level dataset to analyze clinical presentation, LP context, management strategies, and outcomes. We also describe a middle-aged man with orthostatic headache and fever who presented with thin, chronic-appearing bilateral SDH in the setting of SIH. Following a diagnostic LP performed to exclude meningitis, he developed a rapidly progressive, extensive bilateral mixed-density SDH requiring urgent burr-hole evacuation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st3\">\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Fifty-nine studies were included, totaling 485 patients with SIH, of whom 182 had bilateral SDH. From these, we assembled a patient-level cohort of 59 individuals with SIH-associated SDH. The mean age was 47 years, and 81.4% were male. Orthostatic headache was present in 76.3%, whereas coma or stupor occurred in 25.4%. In this cohort, 62.7% had no LP, 30.5% underwent LP only after SDH diagnosis, and 6.8% had clearly post-LP SDH. Management included SDH surgery in 67.8%, epidural blood patch in 67.8%, and open leak repair in 11.9%. The overall SDH recurrence rate was 27.1%, with the highest recurrence (55.6%) in patients who underwent LP after SDH recognition. No deaths were reported.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"st4\">\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Bilateral SDH in the context of SIH mainly affects younger patients and requires a combined strategy of SDH evacuation (when indicated) and leak-directed therapy. Although true post-LP bilateral SDH appears uncommon, LP may reveal or amplify an already unstable low-pressure state. Given the low certainty and incomplete temporal data in many reports, our findings support cautious consideration and avoidance of routine LP solely to document opening pressure in suspected SIH.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.25259\/sni_1304_2025","type":"journal-article","created":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T06:49:45Z","timestamp":1772779785000},"page":"132","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Bilateral subdural hematomas in spontaneous intracranial hypotension: A systematic review with case illustration"],"prefix":"10.25259","volume":"17","author":[{"given":"Negin Safari","family":"Dehnavi","sequence":"first","affiliation":[{"name":"Sina Trauma and Surgery Research Center, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fatemeh Riyahi","family":"Zaniyani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sadegh","family":"Bagherzadeh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alireza","family":"Khoshnevisan","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ushtar","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Neurology, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheyar W.","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Rogers","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohsen","family":"Rostami","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Puya","family":"Alikhani","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Brain and Spine, Morsani College of Medicine, University of South Florida, Tampa, Florida"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milad","family":"Shafizadeh","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2026,3,6]]},"reference":[{"key":"10.25259\/SNI_1304_2025\/ref-1","doi-asserted-by":"crossref","first-page":"94","DOI":"10.4103\/0972-2327.107709","article-title":"Spontaneous intracranial hypotension with bilateral subdural hemorrhage: Is conservative management adequate?","volume":"16","author":"Ahmad","year":"2013","journal-title":"Ann Indian Acad Neurol"},{"key":"10.25259\/SNI_1304_2025\/ref-2","doi-asserted-by":"crossref","first-page":"535","DOI":"10.3174\/ajnr.A2815","article-title":"The role of MR myelography with intrathecal gadolinium in localization of spinal CSF leaks in patients with spontaneous intracranial hypotension","volume":"33","author":"Akbar","year":"2012","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.25259\/SNI_1304_2025\/ref-3","doi-asserted-by":"crossref","first-page":"22","DOI":"10.4103\/2152-7806.127756","article-title":"Thunderclap headache: It is always sub-arachnoid hemorrhage. Is it?-A case report and review","volume":"5","author":"Aladakatti","year":"2014","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_1304_2025\/ref-4","first-page":"e20609","article-title":"Middle meningeal artery embolization as an adjuvant treatment for bilateral chronic subdural hematomas from spontaneous intracranial hypotension: A case report","volume":"13","author":"Barros","year":"2021","journal-title":"Cureus"},{"key":"10.25259\/SNI_1304_2025\/ref-5","doi-asserted-by":"crossref","first-page":"1380","DOI":"10.3171\/2014.6.JNS14550","article-title":"Spinal cerebrospinal fluid leak as the cause of chronic subdural hematomas in nongeriatric patients","volume":"121","author":"Beck","year":"2014","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_1304_2025\/ref-6","doi-asserted-by":"crossref","first-page":"830","DOI":"10.1097\/00006123-200209000-00045","article-title":"Intrathecal saline infusion in the treatment of obtundation associated with spontaneous intracranial hypotension: Technical case report","volume":"51","author":"Binder","year":"2002","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI_1304_2025\/ref-7","doi-asserted-by":"crossref","first-page":"483","DOI":"10.3171\/SPI.2008.9.11.483","article-title":"Occult cervical (C1-2) dural tear causing bilateral recurrent subdural hematomas and repaired with cervical epidural blood patch","volume":"9","author":"Buvanendran","year":"2008","journal-title":"J Neurosurg Spine"},{"key":"10.25259\/SNI_1304_2025\/ref-8","doi-asserted-by":"crossref","first-page":"e181","DOI":"10.1016\/j.crad.2021.11.007","article-title":"Spontaneous intracranial hypotension: The role of radiology in diagnosis and management","volume":"77","author":"Carlton Jones","year":"2022","journal-title":"Clin Radiol"},{"key":"10.25259\/SNI_1304_2025\/ref-9","doi-asserted-by":"crossref","first-page":"54","DOI":"10.1017\/S0317167100011070","article-title":"Spontaneous intracranial hypotension: Case series of rare clinical presentations","volume":"38","author":"Chaudhary","year":"2011","journal-title":"Can J Neurol Sci"},{"key":"10.25259\/SNI_1304_2025\/ref-10","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1136\/jnnp-2023-331166","article-title":"Multidisciplinary consensus guideline for the diagnosis and management of spontaneous intracranial hypotension","volume":"94","author":"Cheema","year":"2023","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"10.25259\/SNI_1304_2025\/ref-11","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/S1726-4901(08)70007-8","article-title":"Bilateral subdural hematomas caused by spontaneous intracranial hypotension","volume":"71","author":"Chen","year":"2008","journal-title":"J Chin Med Assoc"},{"key":"10.25259\/SNI_1304_2025\/ref-12","doi-asserted-by":"crossref","first-page":"199","DOI":"10.1016\/j.fjs.2011.08.012","article-title":"Recurrent chronic subdural hemorrhage due to cervical spinal CSF leak in a young adult: Report of a case","volume":"44","author":"Chen","year":"2011","journal-title":"Formosan J Surg"},{"key":"10.25259\/SNI_1304_2025\/ref-13","doi-asserted-by":"crossref","first-page":"51","DOI":"10.37796\/2211-8039.1417","article-title":"Continuous intrathecal saline infusion for treating refractory spontaneous intracranial hypotension: A case report","volume":"13","author":"Chiu","year":"2023","journal-title":"Biomedicine (Taipei)"},{"key":"10.25259\/SNI_1304_2025\/ref-14","doi-asserted-by":"crossref","first-page":"388","DOI":"10.12998\/wjcc.v10.i1.388","article-title":"Epidural blood patch for spontaneous intracranial hypotension with subdural hematoma: A case report and review of literature","volume":"10","author":"Choi","year":"2022","journal-title":"World J Clin Cases"},{"key":"10.25259\/SNI_1304_2025\/ref-15","doi-asserted-by":"crossref","first-page":"112","DOI":"10.4103\/1793-5482.116390","article-title":"Brain herniation induced by drainage of subdural hematoma in spontaneous intracranial hypotension","volume":"8","author":"Chotai","year":"2013","journal-title":"Asian J Neurosurg"},{"key":"10.25259\/SNI_1304_2025\/ref-16","first-page":"250","article-title":"Spontaneous intracranial hypotension and subdural hematomas treatment management using MMA embolization and target blood patch: A case report","volume":"14","author":"Cirillo","year":"2024","journal-title":"Life (Basel)"},{"key":"10.25259\/SNI_1304_2025\/ref-17","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1186\/1752-1947-8-456","article-title":"Spontaneous cerebrospinal fluid leak following a pilates class: A case report","volume":"8","author":"Davis","year":"2014","journal-title":"J Med Case Rep"},{"key":"10.25259\/SNI_1304_2025\/ref-18","doi-asserted-by":"crossref","first-page":"752","DOI":"10.1136\/jnnp.74.6.752","article-title":"Subdural haematoma: A potentially serious consequence of spontaneous intracranial hypotension","volume":"74","author":"de Noronha","year":"2003","journal-title":"J Neurol Neurosurg Psychiatry"},{"key":"10.25259\/SNI_1304_2025\/ref-19","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1007\/s12028-009-9323-8","article-title":"Coma from worsening spontaneous intracranial hypotension after subdural hematoma evacuation","volume":"12","author":"Dhillon","year":"2010","journal-title":"Neurocrit Care"},{"key":"10.25259\/SNI_1304_2025\/ref-20","doi-asserted-by":"crossref","first-page":"580","DOI":"10.1001\/jamaneurol.2018.4921","article-title":"Assessing spinal cerebrospinal fluid leaks in spontaneous intracranial hypotension with a scoring system based on brain magnetic resonance imaging findings","volume":"76","author":"Dobrocky","year":"2019","journal-title":"JAMA Neurol"},{"key":"10.25259\/SNI_1304_2025\/ref-21","doi-asserted-by":"crossref","first-page":"766","DOI":"10.1148\/radiol.2018180732","article-title":"Cryptogenic cerebrospinal fluid leaks in spontaneous intracranial hypotension: Role of dynamic CT myelography","volume":"289","author":"Dobrocky","year":"2018","journal-title":"Radiology"},{"key":"10.25259\/SNI_1304_2025\/ref-22","first-page":"e77960","article-title":"Diagnosis and management of spontaneous intracranial hypotension due to a CSF leak: A case of spontaneous recovery","volume":"17","author":"Elamin","year":"2025","journal-title":"Cureus"},{"key":"10.25259\/SNI_1304_2025\/ref-23","doi-asserted-by":"crossref","first-page":"868","DOI":"10.3340\/jkns.2022.0061","article-title":"Efficacy of middle meningeal artery embolization in treatment resistant spontaneous intracranial hypotension caused subdural hematoma: Report of two cases and review of the literature","volume":"65","author":"Evran","year":"2022","journal-title":"J Korean Neurosurg Soc"},{"key":"10.25259\/SNI_1304_2025\/ref-24","doi-asserted-by":"crossref","first-page":"1489","DOI":"10.3174\/ajnr.A0621","article-title":"The venous distension sign: A diagnostic sign of intracranial hypotension at MR imaging of the brain","volume":"28","author":"Farb","year":"2007","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.25259\/SNI_1304_2025\/ref-25","doi-asserted-by":"crossref","first-page":"699","DOI":"10.1016\/j.clineuro.2009.06.001","article-title":"Coma resulting from spontaneous intracranial hypotension treated with the epidural blood patch in the Trendelenburg position pre-medicated with acetazolamide","volume":"111","author":"Ferrante","year":"2009","journal-title":"Clin Neurol Neurosurg"},{"key":"10.25259\/SNI_1304_2025\/ref-26","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1111\/j.1468-1331.2009.02913.x","article-title":"Epidural blood patch in Trendelenburg position pre-medicated with acetazolamide to treat spontaneous intracranial hypotension","volume":"17","author":"Ferrante","year":"2010","journal-title":"Eur J Neurol"},{"key":"10.25259\/SNI_1304_2025\/ref-27","doi-asserted-by":"crossref","first-page":"2324","DOI":"10.1016\/j.clineuro.2013.08.028","article-title":"Pseudo-subarachnoid hemorrhage: A potential imaging pitfall associated with spontaneous intracranial hypotension","volume":"115","author":"Ferrante","year":"2013","journal-title":"Clin Neurol Neurosurg"},{"key":"10.25259\/SNI_1304_2025\/ref-28","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1016\/j.anorl.2011.08.005","article-title":"A case of spontaneous intracranial hypotension: from M\u00e9ni\u00e8re-like syndrome to cerebral involvement","volume":"129","author":"Fontaine","year":"2012","journal-title":"Eur Ann Otorhinolaryngol Head Neck Dis"},{"key":"10.25259\/SNI_1304_2025\/ref-29","first-page":"296","article-title":"Epidural blood patch in subdural hematoma due to spontaneous intracranial hypotention: A case report and literature review","volume":"10","author":"Ganjifard","year":"2024","journal-title":"Arch Anesthesiol Crit Care"},{"key":"10.25259\/SNI_1304_2025\/ref-30","doi-asserted-by":"crossref","first-page":"657","DOI":"10.1016\/j.clineuro.2008.03.014","article-title":"Potential value of radionuclide cisternography in diagnosis and management planning of spontaneous intracranial hypotension","volume":"110","author":"Hyun","year":"2008","journal-title":"Clin Neurol Neurosurg"},{"key":"10.25259\/SNI_1304_2025\/ref-31","doi-asserted-by":"crossref","first-page":"642","DOI":"10.3171\/jns.2001.94.4.0642","article-title":"Diagnostic and surgical strategies for intractable spontaneous intracranial hypotension. Case report","volume":"94","author":"Inenaga","year":"2001","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_1304_2025\/ref-32","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1080\/02688690120057655","article-title":"Evaluation of spontaneous intracranial hypotension: Assessment on ICP monitoring and radiological imaging","volume":"15","author":"Ishihara","year":"2001","journal-title":"Br J Neurosurg"},{"key":"10.25259\/SNI_1304_2025\/ref-33","doi-asserted-by":"crossref","first-page":"274","DOI":"10.3340\/jkns.2011.50.3.274","article-title":"Chronic subdural hematoma after spontaneous intracranial hypotension: A case treated with epidural blood patch on c1-2","volume":"50","author":"Kim","year":"2011","journal-title":"J Korean Neurosurg Soc"},{"key":"10.25259\/SNI_1304_2025\/ref-34","doi-asserted-by":"crossref","first-page":"775","DOI":"10.1111\/head.13525","article-title":"Clinical features of patients with spontaneous intracranial hypotension complicated with bilateral subdural fluid collections","volume":"59","author":"Kim","year":"2019","journal-title":"Headache"},{"key":"10.25259\/SNI_1304_2025\/ref-35","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1016\/j.jocn.2024.02.005","article-title":"Spontaneous intracranial hypotension presenting with bilateral subdural hematoma: Decision-making and treatment strategies","volume":"121","author":"Kim","year":"2024","journal-title":"J Clin Neurosci"},{"key":"10.25259\/SNI_1304_2025\/ref-36","doi-asserted-by":"crossref","first-page":"101034","DOI":"10.1016\/j.inat.2020.101034","article-title":"Impact of dural hypoplasia in a patient with spontaneous cerebrospinal fluid leak at atolantoaxial level","volume":"23","author":"Kitagawa","year":"2021","journal-title":"Interdiscipl Neurosurg"},{"key":"10.25259\/SNI_1304_2025\/ref-37","first-page":"754","article-title":"Decubitus CT myelography for detecting subtle CSF leaks in spontaneous intracranial hypotension","volume":"40","author":"Kranz","year":"2019","journal-title":"AJNR Am J Neuroradiol"},{"key":"10.25259\/SNI_1304_2025\/ref-38","doi-asserted-by":"crossref","first-page":"518","DOI":"10.2176\/nmc.51.518","article-title":"Spontaneous intracranial hypotension presenting without orthostatic headache complicated by acute subdural hematoma after drainage for chronic subdural hematoma--case report","volume":"51","author":"Kuramae","year":"2011","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"10.25259\/SNI_1304_2025\/ref-39","doi-asserted-by":"crossref","first-page":"133","DOI":"10.1111\/j.1468-2982.2006.01249.x","article-title":"Subdural haematoma in patients with spontaneous intracranial hypotension","volume":"27","author":"Lai","year":"2007","journal-title":"Cephalalgia"},{"key":"10.25259\/SNI_1304_2025\/ref-40","first-page":"e20099","article-title":"Non-operative management of a pediatric patient with bilateral subdural hematomas in the setting of ruptured arachnoid cyst","volume":"13","author":"Li","year":"2021","journal-title":"Cureus"},{"key":"10.25259\/SNI_1304_2025\/ref-41","doi-asserted-by":"crossref","first-page":"4","DOI":"10.1186\/s10194-016-0708-8","article-title":"The status of diagnosis and treatment to intracranial hypotension, including SIH","volume":"18","author":"Lin","year":"2017","journal-title":"J Headache Pain"},{"key":"10.25259\/SNI_1304_2025\/ref-42","doi-asserted-by":"crossref","first-page":"e49","DOI":"10.1055\/s-0041-1740153","article-title":"Targeted epidural blood patch treatment for refractory spontaneous intracranial hypotension: A case report","volume":"82","author":"Liu","year":"2021","journal-title":"J Neurol Surg Rep"},{"key":"10.25259\/SNI_1304_2025\/ref-43","doi-asserted-by":"crossref","first-page":"1060","DOI":"10.1136\/jnis-2023-020789","article-title":"Direct comparison of digital subtraction myelography versus CT myelography in lateral decubitus position: evaluation of diagnostic yield for cerebrospinal fluid-venous fistulas","volume":"16","author":"L\u00fctzen","year":"2023","journal-title":"J Neurointerv Surg"},{"key":"10.25259\/SNI_1304_2025\/ref-44","doi-asserted-by":"crossref","first-page":"331","DOI":"10.1016\/j.wneu.2020.05.254","article-title":"Acute deterioration in a patient with bilateral chronic subdural hematomas associated with intracranial hypotension treated with an epidural blood patch","volume":"141","author":"Matsuoka","year":"2020","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_1304_2025\/ref-45","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1016\/j.inat.2017.08.009","article-title":"Spontaneous intracranial hypotension resulting in coma: Case report and review of the literature","volume":"11","author":"Merali","year":"2018","journal-title":"Interdiscipl Neurosurg"},{"key":"10.25259\/SNI_1304_2025\/ref-46","doi-asserted-by":"crossref","first-page":"1086","DOI":"10.1212\/CON.0000000000000193","article-title":"Spontaneous intracranial hypotension","volume":"21","author":"Mokri","year":"2015","journal-title":"Continuum (Minneap Minn)"},{"key":"10.25259\/SNI_1304_2025\/ref-47","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1097\/XEB.0000000000000064","article-title":"Conducting systematic reviews of association (etiology): The Joanna Briggs Institute\u2019s approach","volume":"13","author":"Moola","year":"2015","journal-title":"Int J Evid Based Healthc"},{"key":"10.25259\/SNI_1304_2025\/ref-48","doi-asserted-by":"crossref","first-page":"484","DOI":"10.2176\/nmc.40.484","article-title":"Spontaneous intracranial hypotension associated with bilateral chronic subdural hematomas--case report","volume":"40","author":"Murakami","year":"2000","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"10.25259\/SNI_1304_2025\/ref-49","doi-asserted-by":"crossref","first-page":"647","DOI":"10.2176\/nmc.36.647","article-title":"Bilateral chronic subdural hematomas associated with intracranial hypotension--case report","volume":"36","author":"Nakajima","year":"1996","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"10.25259\/SNI_1304_2025\/ref-50","doi-asserted-by":"crossref","first-page":"104320","DOI":"10.1016\/j.bas.2025.104320","article-title":"Management of chronic subdural hematoma in spontaneous intracranial hypotension","volume":"5","author":"Overstijns","year":"2025","journal-title":"Brain Spine"},{"key":"10.25259\/SNI_1304_2025\/ref-51","doi-asserted-by":"crossref","first-page":"n71","DOI":"10.1136\/bmj.n71","article-title":"The PRISMA 2020 statement: An updated guideline for reporting systematic reviews","volume":"372","author":"Page","year":"2021","journal-title":"BMJ"},{"key":"10.25259\/SNI_1304_2025\/ref-52","first-page":"e60199","article-title":"A Severe case of spontaneous intracranial hypotension in an adult Asian male improved with trendelenburg positioning: A case report","volume":"16","author":"Pineda","year":"2024","journal-title":"Cureus"},{"key":"10.25259\/SNI_1304_2025\/ref-53","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1055\/s-2007-977738","article-title":"Spontaneous intracranial hypotension: Case report with subdural hematomas, steroid dependency and clinical improvement after myelography","volume":"68","author":"Platz","year":"2007","journal-title":"Zentralbl Neurochir"},{"key":"10.25259\/SNI_1304_2025\/ref-54","first-page":"e7018","article-title":"Spontaneous intracranial hypotension: Case study and review of the literature","volume":"12","author":"Podkovik","year":"2020","journal-title":"Cureus"},{"key":"10.25259\/SNI_1304_2025\/ref-55","doi-asserted-by":"crossref","first-page":"47","DOI":"10.1097\/01.NAJ.0000450430.97383.64","article-title":"JBI\u2019s systematic reviews: Study selection and critical appraisal","volume":"114","author":"Porritt","year":"2014","journal-title":"Am J Nurs"},{"key":"10.25259\/SNI_1304_2025\/ref-56","doi-asserted-by":"crossref","first-page":"405","DOI":"10.1016\/j.ajem.2025.07.066","article-title":"Posterior fossa subdural hematoma in spontaneous intracranial hypotension","volume":"98","author":"Ray","year":"2025","journal-title":"Am J Emerg Med"},{"key":"10.25259\/SNI_1304_2025\/ref-57","doi-asserted-by":"crossref","first-page":"42","DOI":"10.1046\/j.1468-2982.1997.1701042.x","article-title":"Recurrence of spontaneous intracranial hypotension with subdural hematomas","volume":"17","author":"Sato","year":"1997","journal-title":"Cephalalgia"},{"key":"10.25259\/SNI_1304_2025\/ref-58","doi-asserted-by":"crossref","first-page":"2286","DOI":"10.1001\/jama.295.19.2286","article-title":"Spontaneous spinal cerebrospinal fluid leaks and intracranial hypotension","volume":"295","author":"Schievink","year":"2006","journal-title":"JAMA"},{"key":"10.25259\/SNI_1304_2025\/ref-59","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1007\/s12028-012-9800-3","article-title":"Stroke and death due to spontaneous intracranial hypotension","volume":"18","author":"Schievink","year":"2013","journal-title":"Neurocrit Care"},{"key":"10.25259\/SNI_1304_2025\/ref-60","doi-asserted-by":"crossref","first-page":"e1638","DOI":"10.1212\/WNL.0000000000005477","article-title":"Coma: A serious complication of spontaneous intracranial hypotension","volume":"90","author":"Schievink","year":"2018","journal-title":"Neurology"},{"key":"10.25259\/SNI_1304_2025\/ref-61","first-page":"58","article-title":"Epidural blood patch in spontaneous intracranial hypotension and role of optic nerve sheath diameter: A case report","volume":"12","author":"Shah","year":"2024","journal-title":"J Neuroanaesthesiol Crit Care"},{"key":"10.25259\/SNI_1304_2025\/ref-62","doi-asserted-by":"crossref","first-page":"24","DOI":"10.25259\/SNI_833_2024","article-title":"Early use of targeted blood patch in spontaneous intracranial hypotension presenting with bilateral subdural hematomas and acute infarcts","volume":"16","author":"Shahzad","year":"2025","journal-title":"Surg Neurol Int"},{"key":"10.25259\/SNI_1304_2025\/ref-63","doi-asserted-by":"crossref","first-page":"69","DOI":"10.3340\/jkns.2016.59.1.69","article-title":"Extended pneumocephalus after drainage of chronic subdural hematoma associated with intracranial hypotension: Case report with pathophysiologic consideration","volume":"59","author":"Shin","year":"2016","journal-title":"J Korean Neurosurg Soc"},{"key":"10.25259\/SNI_1304_2025\/ref-64","first-page":"1538","article-title":"Bilateral subdural hematomas and hearing disturbances caused by spontaneous intracranial hypotension","volume":"92","author":"Srimanee","year":"2009","journal-title":"J Med Assoc Thai"},{"key":"10.25259\/SNI_1304_2025\/ref-65","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1055\/s-0040-1721203","article-title":"Recurrent spontaneous bilateral subdural hemorrhage as a consequence of high-cervical spontaneous CSF leak-lessons for neurosurgeons","volume":"10","author":"Subramaniam","year":"2021","journal-title":"Indian J Neurosurg"},{"key":"10.25259\/SNI_1304_2025\/ref-66","doi-asserted-by":"crossref","first-page":"416","DOI":"10.4103\/aer.aer_131_22","article-title":"A single-level epidural blood patch for multiple cerebrospinal fluid leaks: How it works","volume":"16","author":"Swain","year":"2022","journal-title":"Anesth Essays Res"},{"key":"10.25259\/SNI_1304_2025\/ref-67","doi-asserted-by":"crossref","first-page":"69","DOI":"10.2176\/nmc.oa.2015-0032","article-title":"Chronic subdural hematoma associated with spontaneous intracranial hypotension: Therapeutic strategies and outcomes of 55 cases","volume":"56","author":"Takahashi","year":"2016","journal-title":"Neurol Med Chir (Tokyo)"},{"key":"10.25259\/SNI_1304_2025\/ref-68","doi-asserted-by":"crossref","first-page":"e94","DOI":"10.1212\/WNL.0000000000000213","article-title":"Teaching neuroimages: A dangerous complication of spontaneous intracranial hypotension","volume":"82","author":"Tana","year":"2014","journal-title":"Neurology"},{"key":"10.25259\/SNI_1304_2025\/ref-69","doi-asserted-by":"crossref","first-page":"93","DOI":"10.2176\/jns-nmc.2022-0356","article-title":"Two cases of chronic subdural hematoma with spontaneous intracranial hypotention treated with hematoma drainage followed by epidural blood patch under intracranial pressure monitoring","volume":"10","author":"Terakado","year":"2023","journal-title":"NMC Case Rep J"},{"key":"10.25259\/SNI_1304_2025\/ref-70","doi-asserted-by":"crossref","first-page":"76","DOI":"10.1111\/j.1526-4610.2005.t01-1-05013.x","article-title":"Spontaneous intracranial hypotension presenting as mental deterioration","volume":"45","author":"Tsai","year":"2005","journal-title":"Headache"},{"key":"10.25259\/SNI_1304_2025\/ref-71","first-page":"55","article-title":"A rare presentation of spontaneous intracranial hypotension","volume":"24","author":"Uzunk\u00f6pr\u00fc","year":"2018","journal-title":"Turk Norol Derg"},{"key":"10.25259\/SNI_1304_2025\/ref-72","doi-asserted-by":"crossref","first-page":"509","DOI":"10.1007\/s13760-016-0597-2","article-title":"Clinical characteristics of 15 cases of chronic subdural hematomas due to spontaneous intracranial hypotension with spinal cerebrospinal fluid leak","volume":"116","author":"Wan","year":"2016","journal-title":"Acta Neurol Belg"},{"key":"10.25259\/SNI_1304_2025\/ref-73","doi-asserted-by":"crossref","first-page":"6544","DOI":"10.12998\/wjcc.v9.i22.6544","article-title":"Management of an intracranial hypotension patient with diplopia as the primary symptom: A case report","volume":"9","author":"Wei","year":"2021","journal-title":"World J Clin Cases"},{"key":"10.25259\/SNI_1304_2025\/ref-74","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1016\/j.wneu.2019.07.088","article-title":"Reversible, position-dependent midbrain compression in a patient with spontaneous intracranial hypotension","volume":"130","author":"Williams","year":"2019","journal-title":"World Neurosurg"},{"key":"10.25259\/SNI_1304_2025\/ref-75","doi-asserted-by":"crossref","first-page":"e0123616","DOI":"10.1371\/journal.pone.0123616","article-title":"Risk factors for subdural haematoma in patients with spontaneous intracranial hypotension","volume":"10","author":"Xia","year":"2015","journal-title":"PLoS One"},{"key":"10.25259\/SNI_1304_2025\/ref-76","doi-asserted-by":"crossref","first-page":"185","DOI":"10.1097\/WNQ.0b013e31821264d5","article-title":"Management of spontaneous intracranial hypotension with subdural hematoma: Report of 2 cases","volume":"21","author":"Xia","year":"2011","journal-title":"Neurosurg Q"},{"key":"10.25259\/SNI_1304_2025\/ref-77","doi-asserted-by":"crossref","first-page":"273","DOI":"10.1097\/WNQ.0b013e31820111f7","article-title":"Spontaneous intracranial hypotension associated with chronic subdural hematoma successfully treated with burr hole irrigation alone","volume":"20","author":"Yamakawa","year":"2010","journal-title":"Neurosurg Q"},{"key":"10.25259\/SNI_1304_2025\/ref-78","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1186\/s40981-020-00362-3","article-title":"Spontaneous intracranial hypotension associated with cerebral venous thrombosis detected by a sudden seizure: A case report","volume":"6","author":"Yamamoto","year":"2020","journal-title":"JA Clin Rep"},{"key":"10.25259\/SNI_1304_2025\/ref-79","doi-asserted-by":"crossref","first-page":"1089","DOI":"10.3171\/jns.2007.106.6.1089","article-title":"Spontaneous intracranial hypotension and immediate improvement following epidural blood patch placement demonstrated by intracranial pressure monitoring. Case report","volume":"106","author":"Zada","year":"2007","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI_1304_2025\/ref-80","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1177\/0300060516645955","article-title":"Epidural blood patch for spontaneous intracranial hypotension with chronic subdural haematoma: A case report and literature review","volume":"44","author":"Zhang","year":"2016","journal-title":"J Int Med Res"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/bilateral-subdural-hematomas-in-spontaneous-intracranial-hypotension-a-systematic-review-with-case-illustration\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/bilateral-subdural-hematomas-in-spontaneous-intracranial-hypotension-a-systematic-review-with-case-illustration\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T06:49:59Z","timestamp":1772779799000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/bilateral-subdural-hematomas-in-spontaneous-intracranial-hypotension-a-systematic-review-with-case-illustration\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,3,6]]},"references-count":80,"alternative-id":["10.25259\/SNI_1304_2025"],"URL":"https:\/\/doi.org\/10.25259\/sni_1304_2025","relation":{},"ISSN":["2152-7806","2229-5097"],"issn-type":[{"value":"2152-7806","type":"electronic"},{"value":"2229-5097","type":"print"}],"subject":[],"published":{"date-parts":[[2026,3,6]]},"article-number":"132"}}