Monitoring rebound intracranial hypertension by cine MRI after treatment of spontaneous intracranial hypotension in a patient with notable subdural hemorrhage

A 44-year-old man with spontaneous intracranial hypotension complicated by progressive subdural hematoma (SDH) had repeat bleeding during a headache-resolving period. After he underwent epidural blood patching (EBP), rebound intracranial hypertension occurred and was successfully treated with an intravenous osmotic agent. With cine magnetic resonance imaging, we were able to examine the flow dynamics of the cerebrospinal fluid, to verify rebound intracranial hypertension after EBP, and to non-invasively confirm the effectiveness of treatment. Among patients with spontaneous intracranial hypotension complicated with clinically significant SDH, pseudo-normalization of intracranial pressure suggests the presence of acute rebound intracranial hypertension after EBP.