Spontaneous intracranial hypotension: presentation, diagnosis, and treatment.

1327 December 2014 B ecause of cerebrospinal fluid (csF) leak, orthostatic headaches sometimes follow neuraxial blockade or diagnostic lumbar puncture. etiology and treatment are straightforward in those settings, since a site of dural disruption is known.1,2 With patient consent, we present a case in which intracranial hypotension resulted from dural puncture by a vertebral osteophytic spur. This case scenario illustrates the diagnostic dilemma of spontaneous intracranial hypotension (sIH), the role of imaging studies, and the value of empiric lumbar epidural blood patch (LeBP).