Background: Despite the lack of clinical research done, new mutations of COVID-19 are travelling all over the world, and sooner or later, unexpected consequences going to be seen. In October 2020 new variant of SARV-CoV-2 (known as 20H/501.V2 or B1.351) has been found in our province (Eastern Cape), South Africa. This variant has multiple mutations in the spike protein, including K417N, E484K, N501Y. We did an extensive review of the medical literature (It is not a systematic review), looking for all publications regarding spontaneous intracranial hypotension, subdural effusions SARS-CoV-2/COVID-19.
Case Presentation: We also report a case of 46-years-old-female admitted severe COVID-19 in the intensive care unit; all performed investigations confirmed the severity of the infection caused by SARS-CoV-2. Past medical history proved a chronic headache, standard routine CSF analysis, and normal MRI of the brain three months before admission.
The patient recovered from the respiratory pathology and went home, but two weeks later, she developed a postural headache. We suspect spontaneous intracranial hypotension, and the CSF pressure (5.5 cm of H2O) confirmed it. CT scan of the head showed bilateral frontal subdural effusion.
Conclusion: We did not find any published report related to COVID-19, subdural effusion, and intracranial hypotension. We elaborated a few comments and hypotheses to explain this process’s probable pathophysiology.