[Headache in spontaneous cerebrospinal fluid hypotension].

Cerebrospinal fluid hypotension is a rare, incapacitating syndrome characterized by cerebrospinal fluid hypovolemia occurring in the absence of known dural tear. Severe orthostatic headache is the main symptom and clinical examination is usually normal. Magnetic resonance imaging shows the characteristic association of three signs: diffuse pachymeningeal gadolinium enhancement, sagging brain and bilateral subdural collections. Lumbar puncture is contraindicated. The single most effective treatment is lumbar epidural blood patch which cures over 50 percent of the patients and can be repeated in case of recurrence. The search for a dural tear is rarely necessary and surgical treatment is exceptionally required.