Spontaneous intracranial hypotension.

Spontaneous intracranial hypotension (SIH) is an increasingly recognised syndrome. Postural headache with typical findings on magnetic resonance imaging (MRI) are the key to diagnosis. Orthostatic headache, low cerebrospinal fluid opening pressure, and diffuse meningeal enhancement on post-contrast T1-weighted MRI brain studies are the major features of this increasingly recognised syndrome. Headache due to SIH is similar to headache occurring after lumbar puncture. Delay in diagnosing this condition may subject patients to unnecessary procedures and prolong morbidity. We describe a patient with SIH and outline the important clinical and radiographic features of this syndrome. Patients with postural headaches should have brain MRI before lumbar puncture. When correctly diagnosed, SIH management, in most cases, is easy and highly effective.