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What do you do when headache appears clinically attributed to intracranial hypotension but imaging and opening pressure are normal or not obtainable?
In light of a study by Caroll et al., PMID 38820488 on epidural blood patches for patients with headaches attributed to SIH that were non-conforming to ICHD-3 criteria.
Answer from: at Community Practice
Regarding the IHS classification and diagnostic criteria, it is important to remember the following:
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Answer from: at Academic Institution
If one is presenting with clearly positional headaches where my clinical suspicion is high for spontaneous intracranial hypotension, I would start with an empiric lumbar blood patch. I may consider more than one empiric lumbar blood patch. If no improvement is seen, then my next step would depend on...
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at UCLA
In Los Angeles, when we need further expertise, we...
In Los Angeles, when we need further expertise, we...
Answer from: at Academic Institution
I like this paper by Carroll et al., PMID 38820488, and many other good headache clinicians. If you think a headache has clinical characteristics of low CSF pressure headache, you should treat with lying flat and any other non-invasive techniques for a few days. If the headache persists, an epidural...
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at University of Minnesota
Listen to the patient. If symptomatic, treat.
Listen to the patient. If symptomatic, treat.