Paradoxical postural headaches in cerebrospinal fluid leaks

Cephalalgia. 2004 Oct;24(10):883-7. doi: 10.1111/j.1468-2982.2004.00763.x.

Abstract

Two patients with cerebrospinal fluid (CSF) leak, one at the level of fourth thoracic spine and another with undetermined level of leak, presented with paradoxical postural headaches in that the headaches were present when in a horizontal position and resolved if the patients were upright. One patient improved spontaneously and the other responded to a targeted epidural blood patch. Paradoxical postural headache is yet another headache type that can be associated with CSF leak and CSF volume depletion. Its mechanism is uncertain, but it could be related to congestion and dilatation of cerebral venous sinuses and large veins.

Publication types

  • Case Reports

MeSH terms

  • Female
  • Headache / complications
  • Headache / diagnosis*
  • Humans
  • Magnetic Resonance Imaging / methods
  • Middle Aged
  • Subdural Effusion / complications
  • Subdural Effusion / diagnosis*