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Spontaneous intracranial hypotension (SIH) syndrome is characterized by orthostatic headaches, low CSF pressure, and characteristic cranial MRI features. Cases with normal CSF pressure,1 normal cranial MRI,2 or even without postural headaches3 challenge the key features of SIH and broaden the clinical and imaging spectrum of this syndrome. At this time, it is a controversial subject whether the main cause for SIH is CSF volume loss or CSF hypotension;4 CSF dynamics of the spontaneous CSF leak (probably present in all cases of SIH5) may account for the variable presentations of SIH. We describe a case of SIH in which the flow dynamics of the CSF leak are demonstrated and conclude that CSF volume loss is the main cause of this syndrome.
Case report.
A woman aged 31 years was admitted to our hospital complaining of severe headaches appearing shortly after assuming the upright position and improving rapidly in recumbence. She had a history …
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