Orthostatic headache

Orthostatic headache is a medical condition characterized by a headache that occurs when a person stands up and improves when they lie down. This condition is often associated with low cerebrospinal fluid (CSF) pressure, also known as spontaneous intracranial hypotension or SIH.

Symptoms

The primary symptom of an orthostatic headache is a headache that worsens upon standing and improves upon lying down. Other symptoms may include nausea, vomiting, neck pain, tinnitus, changes in hearing, and dizziness.

Causes

Orthostatic headaches are most commonly caused by a decrease in CSF pressure. This can occur due to a spontaneous CSF leak, which can occur without a known cause, or due to a traumatic event, such as a lumbar puncture.

Diagnosis

Diagnosis of orthostatic headache involves a thorough medical history and physical examination. Additional tests may include a magnetic resonance imaging (MRI) scan, a computed tomography (CT) scan, or a lumbar puncture to measure CSF pressure.

Treatment

Treatment for orthostatic headache depends on the underlying cause. If a CSF leak is identified, treatment may involve bed rest, hydration, and caffeine. In some cases, a procedure known as an epidural blood patch may be performed to seal the leak. If no leak is identified, treatment may involve medications to increase CSF production or to reduce pain.

See also

• Headache
• Migraine
• Tension headache
• Cluster headache

References

Orthostatic headache Resources
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