Obstructive hydrocephalus secondary to brainstem sagging in recurrent cerebrospinal fluid–venous fistulas: a diagnostic and therapeutic challenge. Illustrative case

This illustrative case highlights the complexity of treatment in recurrent spinal CVFs and intracranial hypotension. The authors detail the extreme consequences of untreated intracranial hypotension, including obstructive hydrocephalus and progressive bulbar dysfunction. In this context, the necessity of external ventricular drainage in order to equalize transtentorial pressure differentials and restore consciousness is demonstrated. https://thejns.org/doi/10.3171/CASE25680.