Current perspectives on the recognition and diagnosis of low CSF pressure headache syndromes. (3rd October 2022)

• Record Type: Journal Article
• Authors: Giagkou, Nikolaos; Spanou, Ioanna; Mitsikostas, Dimos D.
• Is Part Of: Expert review of neurotherapeutics. Volume 22:Number 10(2022)
• Page Start: 815
• Page End: 827
• Publication Date: 2022-10-03
• Subjects: CSF leak -- low CSF pressure headache -- orthostatic headache -- pachymeningeal enhancement -- post-dural puncture headache -- spontaneous intracranial hypotension; Neuropharmacology -- Periodicals; 615.7805
• DOI: 10.1080/14737175.2022.2152674
• Languages: English
• ISSNs: 1473-7175

Abstract

ABSTRACT: Introduction: Headaches occur when cerebrospinal fluid (CSF) pressure drops following dural puncture or trauma or spontaneously. As the features of these headaches and their accompanying symptoms might not be typical, low CSF pressure headache syndromes, and spontaneous intracranial hypotension in particular, are often misdiagnosed and underdiagnosed. Areas covered: The aim of this narrative review is to summarize the most recent evidence regarding the clinical presentation and the diagnosis of low CSF pressure headache syndromes. Expert opinion: The clinical spectrum low CSF pressure headache syndromes varies significantly and key signs might be missing. Low CSF pressure headache syndromes should be included in the differential diagnosis of any case of refractory headache, even when the headache is not orthostatic, or there are normal neuroimaging findings, and/or lumbar puncture opening pressure is within normal limits. Future research should focus on controlled interventional studies on the treatment of low CSF pressure headache syndromes, which are currently lacking.