Spontaneous Intracranial Hypotension Complicated by Bilateral Cerebral Venous Thrombosis in an Older Adult: A Case Report

Spontaneous intracranial hypotension (SIH) is a rare cause of headaches, sometimes presenting atypically in older adults. We report the case of a woman in her early 70s with chronic frontal headaches, gait imbalance, and transient hand weakness. Initial computed tomography (CT) of the head suggested sinusitis, but venous imaging revealed cerebral venous sinus thrombosis (CVST), prompting anticoagulation with rivaroxaban. Readmission for facial droop showed bilateral subdural hygromas. Multidisciplinary assessment identified SIH as the likely primary condition, with CVST as a complication. Anticoagulation was transitioned to warfarin. The patient recovered fully with resolved CVST on imaging. This case highlights the importance of early multidisciplinary collaboration and clinical vigilance in establishing a timely diagnosis and achieving a favourable outcome in suspected SIH.