Original ArticlesManagement of Spontaneous Intracranial Hypotension With Subdural Hematoma: Report of 2 CasesXia, Ping MSc*,†; Wang, Jin MD*,†; Zhang, Qiaowei MSc*,†; Huang, Meili BSc*,†; Wang, Li MSc*,†; Lu, Ji BSc‡; Lu, Peilin MD*,†; Hu, Xingyue MD*,†Author Information *Department of Neurology, Sir Run Run Shaw Hospital, Affiliated with School of Medicine †Sir Run Run Shaw institute of Clinical Medicine, Zhejiang University, 3 East Qingchun Road, Hangzhou 310016, China ‡Department of Traditional Chinese medicine, Huangyan Traditional medicine Hospital, Huangyan District, Taizhou, Zhejiang Province, China Supported by grants from the Department of Traditional Chinese Medicine of Zhejiang Province (No. 2008CA062). Reprints: Peilin Lu, MD, Department of Neurology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University. The authors declare no conflict of interest. Neurosurgery Quarterly: August 2011 - Volume 21 - Issue 3 - p 185-188 doi: 10.1097/WNQ.0b013e31821264d5 Buy Metrics Abstract Spontaneous intracranial hypotension (SIH) is an increasingly recognized disease characterized by postural headache. Subdural hematoma (SDH) is a severe complication of SIH. We describe 2 patients with SIH who developed bilateral SDHs and outline the typical clinical and neuroimaging findings. After failure of conservative treatment, one patient received epidural blood patch (EBP) and neurosurgical drainage of hematomas and the other was successfully managed by EBP alone without hematoma evacuation. SIH patients with SDH that suffered focal neurological deficits, decreased level of consciousness, or SDH with maximum thickness more than 1 cm were recommended to be treated with surgical drainage, followed by EBP to prevent SDH recurrence. © 2011 Lippincott Williams & Wilkins, Inc.