Superficial siderosis from dural defect with spontaneous intracranial hypotension and epidural fluid collection

65-year-old female patient with a history of significant prior remote trauma with a 6-year history of decreased hearing and vertigo.
(A) Coronal T2-weighted MRI showing evidence of cerebellar hemosiderin deposition (arrows). Sagittal (B) and axial (G) T2-weighted cervical spine MRI showing ventral epidural fluid from C4 to T2 (arrows). Sagittal (C) and axial (H) T2-weighted thoracic spine MRI showing ventral epidural fluid at T7 to T8 (arrows). CT myelogram showing leak at T8 to T9 on axial (D) and sagittal (I) images showing extravasated dye (arrows); also note contrast opacification of fluid collection (E; arrow). (F) Coronal T1 with contrast MRI showing diffuse and symmetric pachymeningeal enhancement suggestive of spontaneous intracranial hypotension (arrows). (J) Sagittal T2-weighted thoracic spine MRI done 3 months after leak repair showing resolution on the epidural fluid; also note postoperative changes related to the laminectomy.