Orthostatic Headaches

The syndrome of low-pressure CSF headaches was first recognized following diagnostic lumbar puncture. In the 1940s and 50s, Woltman in the United States ( [1] ) and Schaltenbrand in Germany ( [2] ) described "spontaneous" posture-related low-pressure headaches that did not develop after lumbar puncture. In spontaneous CSF leaks, there is sometimes a history of strenuous activity or trivial traumatic injury. Mokri et al. ( [3] ) have recently described cases associated with postural tachycardia syndrome (POTS). Schievink et al.( [4] ) have also linked intracranial hypotension with connective tissue disorders. Ferrante et al. ( [5] ) reported a case of Marfan's syndrome and postural headache in whom MRI myelography revealed bilateral multiple large meningeal diverticula at sacral nerve roots level; the authors postulated that