Spontaneous intracranial hypotension: an interesting cause of intractable headache

ABSTRACT

Intracranial hypotension [ICH] is a benign syndrome which is often under-diagnosed. It is characterized by orthostatic headache which is predominantly occipital. ICH is diagnosed in the presence of a typical history and characteristic imaging findings. Further confirmation by Lumbar Puncture to document low CSF pressure is necessary in some cases. Treatment is mainly conservative. However, surgical intervention might be required if conservative measures fail. In this report we present a case of 42 year old male patient who presented with symptoms of orthostatic occipital headache of three months duration and was subsequently diagnosed with Intracranial Hypotension based of characteristic MRI findings: