1. aka SIH, or spontaneous intracranial hypotension/ spontaenous CSF leak
2. Diagnostic criteria (journal Headache, 2011) : a. orthostatic headache b. no recent dural puncture c. not attributable to another disorder and d. at least one of the following: (1) low OP < 60 mm H20 (2) sustained improvement after epidural blood patches (3) demonstrated active leak (4) cranial MRI showing brain sagging or pachymeningeal enhancement
3. Clinical pearl: MRI without contrast can lead to false diagnosis of Chiari malformation and repair of which will not help.
4. Headaches can be frontal/occipital/holocephalic/ cervical interscapular/ nonorthostatic or lingering nonorthostatic before or after orthostatic/ thunderclap headache/ cough headache/ second half of the day headache/ acephalgic forms
5. May require multiple blood patches to fix
2. Diagnostic criteria (journal Headache, 2011) : a. orthostatic headache b. no recent dural puncture c. not attributable to another disorder and d. at least one of the following: (1) low OP < 60 mm H20 (2) sustained improvement after epidural blood patches (3) demonstrated active leak (4) cranial MRI showing brain sagging or pachymeningeal enhancement
3. Clinical pearl: MRI without contrast can lead to false diagnosis of Chiari malformation and repair of which will not help.
4. Headaches can be frontal/occipital/holocephalic/ cervical interscapular/ nonorthostatic or lingering nonorthostatic before or after orthostatic/ thunderclap headache/ cough headache/ second half of the day headache/ acephalgic forms
5. May require multiple blood patches to fix
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