Intracranial Hypotension

Intracranial hypotension occurs when imbalance in the production, absorption, or flow of cerebrospinal fluid (CSF) leads to low intracranial pressure and sagging of the brain within the skull. This may cause traction on connected nerves – leading to postural headaches. Intracranial hypotension most commonly occurs from a persistent CSF leak after lumbar puncture but may also be spontaneous. Typically, headaches are described as throbbing or dull pain – which may be generalized or focal. Pain may intensify upon standing or sitting upright and relieved with recumbency. Associated signs and symptoms may include:

Nausea and/or vomiting
Neck pain or stiffness
Dizziness
Changes in hearing
Visual changes (blurred vision, seeing double)

A detailed history, a physical examination, blood work and possibly neuro imaging is needed to diagnose and/or treat intracranial hypotensive headaches.