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An overlooked cause of subdural effusions
  1. Yan-Lin Li1,2,
  2. Chi Sum Tsang2
  1. 1 Department of Radiology, Queen Mary Hospital, University of Hong Kong, Pokfulam, Hong Kong
  2. 2 Department of Neurosurgery, Queen Elizabeth Hospital, Hong Kong, Hong Kong
  1. Correspondence to Dr Yan-Lin Li,{at}


A middle-aged man presented with progressive confusion. Initial brain CT was misinterpreted to have ‘cerebral atrophy and bilateral subdural effusions’ by the emergency physician, and the patient was admitted to a medical ward for further investigation. Two days later, the patient experienced acute neurological deterioration, and burr hole drainage was performed to relieve the effusions. It was later confirmed that the effusions were caused by intracranial hypotension secondary to spinal cerebrospinal fluid leakage. The patient improved on conservative treatment with no lasting neurological sequela.

  • emergency medicine
  • neuroimaging
  • radiology
  • neurosurgery

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  • Contributors Both Y-LL and CST were involved in preparing the manuscript and caring for the patient.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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