Epidural blood patch (EBP) is an effective method for patients suffering from spontaneous intracranial hypotension (SIH). Because the clinical symptoms dramatically improved after EBP, the immediate increase in the intracranial pressure from the direct sealing of the spinal cerebrospinal fluid (CSF) leak has been proposed. However, this hypothesis was not proved according to the real-time ICP monitoring. Therefore, the real effect of EBP is still unknown. We report a case of SIH resulting from the spinal CSF leak. EBPs were performed and ICP levels were analyzed based on the real-time ICP monitoring. His previous neurologic deficit improved dramatically after EBPs. The decreased pressure gradient may be the reason for patients with dramatic recovery from SIH after EBP.