• Figen Gökçay, Can Eyigör, Ece Bayram, Ilknur Dönmez, and Meltem Uyar.
• Department of Neurology, Ege University Faculty of Medicine, İzmir, Turkey.
• Agri. 2010 Oct 1; 22 (4): 170-4.

AbstractIntracranial hypotension is usually seen in middle-aged adults and appears with orthostatic headache. It is characterized by low cerebrospinal fluid (CSF) pressure and pachymeningeal-dural thickening on magnetic resonance imaging (MRI). Lumbar puncture, dural rupture with CSF leakage secondary to spinal anesthesia or spinal traumas, and under-production or over-absorption of CSF due to some metabolic events such as dehydration, uremia and diabetic coma are the main etiologic factors. It is sometimes considered as idiopathic when no etiologic factor is present. In addition, some connective tissue disorders have risk of CSF leakage due to spontaneous dural rupture. Neck pain, tinnitus, nausea and vomiting, and diplopia may accompany headache. CSF leakage can be identified by computerized tomography (CT) myelography, CSF-flow MRI, and radionuclide cisternography. Bed rest, fluid resuscitation, caffeine, theophylline, and non-steroidal antiinflammatory drugs (NSAIDs) are important treatment options. In patients resistant to therapy, interventional measures such as epidural saline or blood patch can be applied. In this case report, we evaluated the results of pain treatment options in a patient having headache due to intracranial hypotension who was hospitalized in the Neurology Department of Ege University Hospital.

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