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intracranial hypotension headache


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An increasingly recognized type of persistant headache in a patient with no history of headaches. Features include headache that is worse on standing and resolves on lying flat. It may be associated with other symptoms, such as dizziness, tinnitus, and (rarely) diplopia. The commonest cause is a complication of lumbar puncture, but it may occur spontaneously (spontaneous intracranial hypotension) after a dural tear resulting in a leak of cerebrospinal fluid. Treatment is with bed rest and increased intake of fluids; caffeine orally or intravenously is also used. In cases that do not resolve, an epidural blood patch procedure is performed, in which a small quantity of the patient’s blood is slowly injected into the epidural space to seal the leak.

Subjects: Medicine and Health.


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