Overview
This refers to a headache that is caused by low cerebrospinal fluid (CSF) pressure in the head. Cerebrospinal fluid leaks and intracranial hypotension Cerebrospinal fluid (CSF) is the fluid that surrounds the brain and spine, and is contained by the dura (a membrane). Rarely, a tear in this membrane can allow CSF to leak out, lowering the volume and pressure of CSF. This is known as intracranial hypotension. This in turn causes a headache. A tear can happen as a result of an underlying medical condition, a lumbar puncture, surgery, trauma, or it can happen spontaneously for no apparent reason – although this is uncommon. Although generally not life threatening, some CSF leaks can result in severe headaches and the symptoms can be very debilitating and disabling. If no cause is identified, it is termed idiopathic intracranial hypotension. Due to gravity, the pressure in the head will be equal to that of the spine when you are lying flat and will be lower when upright.
Symptoms & Diagnosis
Patients with low pressure headaches will describe a headache which worsens after minutes of being upright and is improved on laying flat. This pattern may become less obvious with time. Patients may also describe a worsening of their headache towards the end of the day. Some people may also experience other symptoms, including neck pain and stiffness, nausea, problems with hearing, vision changes and sensitivity to light (photophobia), concentration issues and fatigue.
Imaging of the head and spine, by way of an MRI are normally carried out to investigate this. However, normal imaging is not uncommon and does not exclude the diagnosis. More specialised tests including CT myelography may be needed to pin point the exact location of a leak if not already known.
Treatments, Key Areas We Specialise In & Prognosis
Request a Consultation
Our experienced team would be more than happy to help. To book a consultation, please click on the button below and we shall follow up in due course. The Headache Centre is here to help you every step of the way.
The Private Consulting Rooms