Journal Article

Spontaneous Intracranial Hypotension in a Patient with Systemic Lupus Erythematosus and End-Stage Renal Failure: A Case Report and a Literature Review

Paterakis, Konstantinos, Vlychou, Marianna, Kalogeras, Adamantios, Fountas, Kostas N., Arnaoutoglou, Eleni, Brotis, Alexandros, Spiliotopoulos, Theodosios, Arvaniti, Christina, Dardiotis, Efthimios, Karagianni, Maria, Petsiti, Argiro

2025

Overview

Background and Objectives: End-stage renal failure (ESRF) patients are at an increased risk of various neurological complications, particularly after hemodialysis. The current case report describes a rare presentation of spontaneous intracranial hypotension (SIH) in a patient with ESRF caused by systemic lupus erythematosus (SLE). Methods: We present our case report. We also performed a systematic literature search in PubMed, Scopus, and Dimensions for the current literature review. Results: A total of 296 unique articles were identified, and their full text was retrieved. However, only one case report was relevant to our study and is summarized thereunder. The treatment approach involved high-dose intravenous steroids, surgical evacuation of the cranial subdural collections, and epidural blood patches to seal the presumed dural defect. Conclusions: This case report describes a rare presentation of SIH in a young patient with ESRF due to SLE. Diagnostic imaging revealed extensive subdural and epidural fluid collections in the brain and spinal cord, respectively, along with a few T2 FLAIR hyperintensities noted in the right thalamus, left cerebellar hemisphere, and right occipital gyrus that subsequently resolved. The treatment approach involved high-dose intravenous steroids, surgical evacuation of the cranial subdural collections, and epidural blood patches to seal the presumed dural defect.

• Publisher: MDPI AG,MDPI
• Subject: Antibiotics / Case Report / Case reports / Cerebellum / Cerebrospinal fluid / Connective tissue / Consciousness / cranial subdural collections / Edema / End-stage renal disease / end-stage renal failure / Epidural / epidural blood patches / Headaches / Hemispheric laterality / Hemodialysis / Hypertension / Hypotension / Intravenous administration / Kidney diseases / Kidney failure / Literature reviews / Lupus / Magnetic resonance imaging / Medical colleges / Medical personnel / Nephrology / Neuroimaging / Neurological complications / Patients / Renal failure / Skull / Spinal cord / spontaneous intracranial hypotension / Steroid hormones / Steroids / Streptococcus infections / surgical evacuation / Systemic lupus erythematosus / Transplants & implants