Intracranial hypotension and PRES: Case report

Silvia Pugliese, V. Finocchi, M. L. Borgia, C. Nania, B. Della Vella, A. Pierallini, A. Bozzao

Research output: Contribution to journalArticlepeer-review


We report a case of a woman presenting, 7 days after epidural analgesia for a caesarean section, to the emergency room for a worsening of the headache and tonico-clonic seizures. MRI showed alterations suggestive of the presence of intracranial hypotension (IH) as well as evidence of posterior reversible encephalopathy syndrome (PRES). She was treated with a blood patch which leads to the prompt regression of the clinical symptoms and follow-up MRI, after 15 days, showed complete resolution of radiological alterations. The possible pathogenetic relationship between IH, secondary to the inadvertent dural puncture, and PRES is discussed. We suggest that venous stagnation and hydrostatic edema, secondary to intracranial hypotension, probably played a crucial role in the pathogenesis of PRES.

Original languageEnglish
Pages (from-to)437-440
Number of pages4
JournalJournal of Headache and Pain
Issue number5
Publication statusPublished - Oct 2010


  • Epidural analgesia
  • Headache
  • Intracranial hypotension
  • MRI
  • PRES

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine
  • Clinical Neurology


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