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Review paper

A thin line between Meniere’s disease and spontaneous intracranial hypotension syndrome

By
Iva Botica ,
Iva Botica
Contact Iva Botica

Department of Otorhinolaryngology, University Hospital Centre, Zagreb, Romania

Anđelko Vrca ,
Anđelko Vrca

Department of Neurology, University Hospital Clinic Dubrava, Croatia

Martina Špero ,
Martina Špero

Department of Radiology, University Hospital Clinic Dubrava, Croatia

Marin Šubarić ,
Marin Šubarić

Department of Otorhinolaryngology, University Hospital Clinic Dubrava, Croatia

Tomislav Carić ,
Tomislav Carić
Marija Vrca Botica ,
Marija Vrca Botica

Department of Family Medicine, School of Public Health ‘’Andrija Štampar’’, University of Zagreb, Zagreb, Croatia

Jelena Kovačić ,
Jelena Kovačić

Department of Otorhinolaryngology, University Hospital Clinic Dubrava, Croatia

Kristijan Makaruha ,
Kristijan Makaruha

Department of Otorhinolaryngology, Clinical Hospital Merkur, Zagreb, Croatia

Aleksandra Roglić
Aleksandra Roglić

Department of Radiology, University Hospital Centre, Zagreb, Croatia

Abstract

Aim
To point out the similarity of Meniere disease and spontaneous intracranial hypotension and difference of their treatment.
Methods
A case of a 54-year-old male patient with previously diagnosed Meniere’s disease and newly diagnosed spontaneous
intracranial hypotension syndrome is presented. Additional neuroradiological examination, Brain contrast-enhanced MRI and MR myelography were used for diagnosis.
Results
Due to deterioration of vertigo, hearing loss and tinnitus in the right ear the patient was referred to the additional neuroradiological examination which confirmed the diagnosis of spontaneous intracranial hypotension syndrome. Brain contrast-enhanced MRI showed increased pachymeningeal contrast enhancement, and MR myelography identified the location of CSF leak. The patient was successfully treated conservatively.
Conclusion
According to our knowledge this is the fifth case report of Meniere’s disease and spontaneous intracranial hypotension coexistence. Both diseases have similar clinical presentation and initial treatment. We suggest procedures of additional examination when the treatment fails and initial diagnosis becomes questionable.

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