# Spontaneous Intracranial Hypotension in Pregnancy with Aggravated Comorbidity: A Case Report and Review of Diagnostic and Management Challenges

## TL;DR

This case report highlights the challenges of diagnosing and managing spontaneous intracranial hypotension in a pregnant woman with additional health issues.

## Contribution

The paper presents a rare case of SIH during pregnancy and emphasizes the need for a multidisciplinary approach in such complex scenarios.

## Key findings

- SIH can present with orthostatic headache and facial sinus tenderness during pregnancy.
- Diagnosis of SIH in pregnancy is complicated by overlapping symptoms and limited diagnostic options.
- A multidisciplinary approach is crucial for managing neurological symptoms in pregnant patients.

## Abstract

Background and Clinical Significance: Spontaneous intracranial hypotension (SIH) is a rare cause of headache characterised by cerebrospinal fluid (CSF) leakage, with an estimated incidence of 3.7 to 5 cases per 100,000 per year, peaking around the age of 40 years. Its diagnosis and management are particularly challenging in pregnancy due to overlapping symptoms and limited diagnostic options. Case Presentation: We report the case of a 42-year-old pregnant woman at 14 weeks of gestation presenting with a history of orthostatic headache and facial sinus tenderness, later diagnosed as spontaneous intracranial hypotension. Conclusions: Headache is a common clinical symptom that may be associated with a wide spectrum of underlying conditions, ranging from benign causes such as migraine or tension-type headache to potentially life-threatening pathologies, including subarachnoid haemorrhage. This case illustrates the diagnostic complexity of SIH in pregnancy and the importance of a multidisciplinary approach and vigilance for neurological symptoms during pregnancy.