A rare and unusual case of spontaneous intracranial hypotension in a woman with congenital left hemipelvic dysplasia

Spontaneous intracranial hypotension (SIH) occurs from cerebrospinal fluid (CSF) leak in the absence of trauma or intervention. This entity is a rare but important cause of positional headaches, as the treatment options differ greatly from those for its mimic diagnoses, such as migraines or meningitis. Known causes of spontaneous CSF leak include mechanical Dural tear or dehiscence of a meningeal diverticulum/cyst. The majority of reported cases which occur from mechanical tearing of the dura are caused by spinal osteophytes. We present a unique case of a young female adult with spontaneous CSF leak suspected to be secondary to a combination of congenital pelvic dysplasia, a prior pathologic pelvic fracture, and an inciting event that resulted in shearing of a lumbosacral nerve root sheath.