Abstract : Spontaneous intracranial hypotension (SIH) is a syndrome characterized by orthostatic headache, low cerebrospinal fluid (CSF) pressure and diffuse pachymeningeal enhancement on brain magnetic resonance imaging (MRI). With advancements in imaging techniques, increased instances of SIH have been reported. We present a case of a 33-year-old man presented with SIH. An epidural blood patch at the lumbar level was performed. The patient had atypical chronic mood and behavioural symptoms with subacute onset of postural headache and tinnitus. Though MRI spine did not detect a CSF leak, there was subdural fluid collections and he responded well to an epidural blood patch done at the lumbar level. His headache and tinnitus gradually recovered over a period of two months. Whereas mood and behavioural symptoms improved at a slower rate. An epidural blood patch seems to have an advantage in SIH despite absence of a CSF leak.