Houdingsafhankelijke hoofdpijn door spontane intracraniële hypotensie

Translated title of the contribution: Posture-dependent headache caused by spontaneous intracranial hypotension

Mirjam E. Belderbos, G. J. Amelink, Jan Willem Dankbaar, F. H.H. Linn

Research output: Contribution to journalArticlepeer-review


A 36-year-old woman presented with a 3-4 month history of severe, progressive headache. The headache was characterized by postural variation, with excruciating headache in the upright position and near-immediate relief upon recumbence. There was no history of trauma or lumbar puncture. Gadolineum-enhanced brain MRI revealed abnormalities characteristic intracranial hypotension. Spinal MRI showed a longitudinal extradural fluid collection; a localization of the dural defect was not found. The patient was treated with caffeine, bed rest and lumbar epidural blood patches; she recovered completely. Severe orthostatic headache which aggravates upon standing and is relieved by recumbence, can be caused by spontaneous intracranial hypotension. Recognition of its characteristic symptoms is needed for timely referral. Treatment is usually successful and can prevent life-threatening complications.

Translated title of the contributionPosture-dependent headache caused by spontaneous intracranial hypotension
Original languageDutch
Article numberD5411
JournalNederlands Tijdschrift voor Geneeskunde
Issue number15
Publication statusPublished - 1 Apr 2021


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