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Spontaneous low cerebrospinal fluid pressure headache.
1Department of Internal Medicine, Temple University Hospital, Philadelphia, PA.
Headache
|March 1, 1990
Summary
Spontaneous low cerebrospinal fluid pressure, caused by cerebrospinal fluid (CSF) hyperabsorption, can cause headaches. This condition was successfully treated with blood patches and caffeine.
Area of Science:
- Neurology
- Neurosurgery
- Nephrology
Background:
- Headache on arising, relieved by recumbency, suggests intracranial pressure changes.
- Spontaneous low cerebrospinal fluid pressure is a recognized neurological condition.
- Cerebrospinal fluid (CSF) hyperabsorption can lead to low pressure headaches.
Observation:
- A 69-year-old man presented with positional headaches.
- Clinical, laboratory, and radiographic findings indicated spontaneous low CSF pressure.
- Cisternography revealed rapid CSF accumulation in kidneys and bladder, suggesting hyperabsorption.
Findings:
- The patient's condition was consistent with CSF hyperabsorption.
- No evidence of a CSF leak was identified via cisternography.
- Treatment with blood patches and oral caffeine effectively controlled the headaches.
Implications:
- This case highlights CSF hyperabsorption as a cause of low pressure headaches.
- Cisternography can be valuable in diagnosing CSF pressure dysregulation.
- A multimodal treatment approach, including blood patches and caffeine, can be effective.