Headache and Pain Research

Case Reports

Spontaneous Intracranial Hypotension after Airplane Travel: Ho Jin Hwang, Jiyun Park, Sun Jae Moon, Dong Hyun Hwang, Kyongha Baek, Young Seo Kim; Korean J Headache. 2023;24(2):77-79. Published online December 31, 2023

Abstract PDF: Spontaneous intracranial hypotension usually manifests orthostatic headache caused by cerebrospinal fluid leakage without procedure or trauma to meninges. There was temporal relationship between intracranial hypotension and various precipitating factors such as positional changes, valsalva maneuver, minor trauma and only rarely airplane travel. Here, we report the first korean case of spontaneous intracranial hypotension after airplane travel. A 37-year-old woman presented with orthostatic headache after airplane travel. Her cerebrospinal fluid pressure is 55 mmCSF and cervical spinal level of cerebrospinal fluid leakage confirmed by cisternography. Her symptoms resolved after the epidural blood patch and she was later discharged without any complications.

Paradoxical Postural Headache in Spontaneous Intracranial Hypotension with Infratentorial Superficial Siderosis: Dae Woong Bae, Min Seung Kim, Soo-Jin Cho; Korean J Headache. 2023;24(1):20-23. Published online June 30, 2023

Abstract PDF: Spontaneous intracranial hypotension is characterized by orthostatic headache caused by cerebrospinal fluid (CSF) leakage. However, clinical presentation of SIH is variable, and normal or high intracranial pressure in CSF study is not uncommon. Infratentorial superficial siderosis (ISS) shares similar pathomechanism with SIH, as developed after chronic CSF leakage, whilst several years of latency after SIH onset. Here, we report a 47-year-old male patient who had experienced prominent orthostatic headache twenty years before, and presented reverse-orthostatic headache in this time, accompanying with radiological features of SIH and ISS in brain magnetic resonance imaging (MRI). CSF leakage was confirmed by spinal MRI and MR myelography, and his headache was aggravated after epidural blood patch.

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