Headache Education Center

Headache attributed to low cerebrospinal fluid



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This headache is also known as intracranial hypotension, or low-pressure headache. It is characterized by its worsening upon standing (orthostatic) and walking, and improving or resolving when lying down. This is caused by low cerebrospinal fluid (CSF) pressure (intracranial hypotension), usually from CSF leakage. It is often accompanied by ringing in the ears (tinnitus), neck pain, hearing changes, sensitivity to light (photophobia) and/or nausea. It resolves after normalization of CSF pressure and sealing of the CSF leak. It is diagnosed by a low CSF pressure (less than 60 mm CSF) on lumbar puncture and/or evidence of a CSF leak on neuroimaging (especially with a brain MRI with contrast).

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