Spontaneous intracranial hypotension in Hashimoto's thyroiditis: A case report

RATIONALE: Autoimmune thyroid diseases (ATDs) seldom affect intracranial pressure. Here, we describe a case of spontaneous intracranial hypotension (SIH) related to Hashimoto's thyroiditis (HT), which has never been previously published. PATIENT CONCERNS: A 54-year-old woman was admitted to our hospital due to sudden-onset postural headache, neck pain stiffness, visual blurring, nausea and vomiting. The headache was aggravated when the patient sat or stood up yet rapidly resolved within 1 minute after recumbency. DIAGNOSIS: The patient had a grade 1a diffusely palpable thyroid gland and the laboratory report revealed elevated titers of anti-thyroid antibodies, a diagnosis of HT was established. Gadolinium-enhanced magnetic resonance imaging exhibited dilatation of the venous sinuses, obvious diffuse pachymeningeal enhancement, and narrowing of the ventricular system, combined with the lumbar puncture pressure was 60 mmH(2)0 in the lateral recumbent position, and a diagnosis of SIH was eatablished. INTERVENTIONS: The patient was placed on strict bed rest and hydrated for 15 days. OUTCOMES: The headache was gradually relieved, a follow-up at 1 month after discharge revealed that the patient could stand and function normally. LESSONS: SIH can be related to ATD.