An unusual postural headache: a case report

Henry Pollard,Rachel Pollard

doi:10.1186/s12998-020-00347-0

Henry Pollard, Rachel Pollard

Open Access

https://doi.org/10.1186/s12998-020-00347-0

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Journal: Chiropractic & Manual Therapies	Publication Date: Nov 13, 2020
Citations: 1	License type: open-access

Affiliation: Bond University

Abstract

BackgroundThis paper presents a case of an evolving unusual thunderclap headache that presented to a chiropractor.Case presentationThe intense “migraine-like” headache was aggravated by standing up and relieved substantially when lying down. This low pressure, orthostatic headache was diagnosed as a spontaneous intracranial hypotension (SIH) secondary to a spontaneous tear of the dura. It was referred to the local hospital for management with autogolous blood injection to form an epidural blood patch of the defect. It resolved substantially within 3 days.ConclusionsThe significance of key features in the history and examination and how if not recognised and subsequently treated with manual therapy, the dural tear could be attributed to the treatment of the chiropractor, a treatment that would typically involve cervical manipulation. Discussion is provided of the implications of a missed diagnosis and possible subsequent chiropractic management with the evolving SIH being attributed to the chiropractic intervention rather than its true “spontaneous” nature.

Highlights

ConclusionsThe significance of key features in the history and examination and how if not recognised and subsequently treated with manual therapy, the dural tear could be attributed to the treatment of the chiropractor, a treatment that would typically involve cervical manipulation
This paper presents a case of an evolving unusual thunderclap headache that presented to a chiropractor.Case presentation: The intense “migraine-like” headache was aggravated by standing up and relieved substantially when lying down
This paper presents an example of a headache that was both new and intense

Summary

Conclusions

The significance of key features in the history and examination and how if not recognised and subsequently treated with manual therapy, the dural tear could be attributed to the treatment of the chiropractor, a treatment that would typically involve cervical manipulation.

Findings

Background

Discussion and conclusions