What do you do when headache appears clinically attributed to intracranial hypotension but imaging and opening pressure are normal or not obtainable?

Regarding the IHS classification and diagnostic criteria, it is important to remember the following:

1. The initiative came from Glaxo Pharmaceuticals in order to make it possible for the company to pursue the development of sumatriptan for migraine abortion globally. The company also paid for the fir...

If one is presenting with clearly positional headaches where my clinical suspicion is high for spontaneous intracranial hypotension, I would start with an empiric lumbar blood patch. I may consider more than one empiric lumbar blood patch. If no improvement is seen, then my next step would depend on...

I like this paper by Carroll et al., PMID 38820488, and many other good headache clinicians. If you think a headache has clinical characteristics of low CSF pressure headache, you should treat with lying flat and any other non-invasive techniques for a few days. If the headache persists, an epidural...