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• Vol.61 No.3
• CLINICA NEUROL, 61: 172−176, 2021
• Vol.61 No.3 contents

Case Report

Spontaneous intracranial hypotension complicated by atlantoaxial subluxation: a case report

Naoya Yamazaki, M.D.¹⁾, Doijiri Ryosuke, M.D.¹⁾, Eriko Yamaguchi, M.D.¹), Ken Takahashi, M.D.¹⁾, Hiroaki Takahashi, Ph.D.¹⁾ and Takahiko Kikuchi, Ph.D.¹⁾

¹⁾ Department of Neurology, Iwate Prefectural Central Hospital

A 54-year-old woman presented at the hospital with headache and posterior neck pain, which worsened when standing or in the sitting position and improved when in the supine position. A diagnosis of rheumatoid arthritis was made at the age ofin 33 years, and the patient has been taking methotrexate and methylprednisolone. Cervical MRI and magnetic resonance myelography showed the appearance of CSF leakage, resulting in a diagnosis of spontaneous intracranial hypotension. A diagnosis of atlantoaxial subluxation was also made based on the abnormal anterior position of the atlas (C1) in the cervical X-ray image. The CSF leakage corresponded with the atlantoaxial subluxation region, which indicated that spontaneous intracranial hypotension was caused by the compression of the dura mater. These symptoms were improved following treatment with the intravenous drip of the extracellular fluids, and she was discharged from the hospital on day 25. The disruption of the dura matter induced by atlantoaxial subluxation is a rare complication but is worth considering when determining the etiology of spontaneous intracranial hypotension.
Full Text of this Article in Japanese PDF (1640K) 　　　　 Full Text of this Article in English HTML

(CLINICA NEUROL, 61: 172−176, 2021)
key words: spontaneous intracranial hypotension, atlantoaxial subluxation, rheumatoid arthritis

(Received: 26-Jun-20)