Intracranial hypotension (low cerebrospinal fluid volume and pressure) from a spinal CSF leak is increasingly recognized as a cause of SUBDURAL FLUID OR BLOOD COLLECTIONS. The subdural space is just under the dural layer of the meninges, the connective tissue that surrounds the brain and spinal cord.

These may be seen on cranial (brain) MRI.
– Subdural hygromas = collection of fluid in subdural space
– Subdural hematomas = collection of blood in subdural space (see image)
While the latter may require surgical evacuation, in stable patients, these usually resolve with treatment of the underlying spinal CSF leak.

CEREBRAL VENOUS THROMBOSIS is an uncommon complication of spinal CSF leaking and normally requires treatment with anticoagulation. It is suspected when the character of the headache changes.