Brain sagging syndrome: Occult cerebrospinal fluid leakage as a cause of failed brain expansion after removal of bilateral chronic subdural hematomas

In the case of bilateral CSDH with early postoperative recurrence, a search for the presence of occult CSF leakage may be warranted. The term "brain sagging syndrome" or "brain sagging dementia" has been proposed to describe cognitive impairments due both to the brain compression by the CSDH and to the brain sagging by the CSF leakage. The absence of orthostatic headache may not necessarily exclude the presence of CSF leakage.