Frontotemporal brain sagging syndrome is a dementia associated with
hypersomnolence, personality changes, and features of intracranial
hypotension on magnetic resonance imaging. The literature is sparse with
respect to treatment options; many patients simply worsen. We present a case
in which this syndrome responded to lumbar dural reduction surgery.
Postoperative magnetic resonance imaging indicated normalization of brain
sagging and lumbar intrathecal pressure. Although no evidence of
cerebrospinal leak was found, extremely thin dura was noted
intraoperatively, suggesting that a thin and incompetent dura could result
in this low-pressure syndrome. Clinicians who encounter this syndrome should
consider dural reduction surgery as a treatment strategy.