Abstract
Headaches attributed to low cerebrospinal fluid (CSF) pressure are described as orthostatic headaches caused by spontaneous or secondary low CSF pressure or CSF leakages. Regardless of the cause, CFS leaks may lead to intracranial hypotension (IH) and influence cerebral blood flow (CBF). When CSF volume decreases, a compensative increase in intracranial blood volume and cerebral vasodilatation occurs. Sinking of the brain and traction on pain-sensitive structures are thought to be the causes of orthostatic headaches. Although there are many studies concerning CBF during intracranial hypertension, little is known about CBF characteristics during low intracranial pressure. The aim of this review is to examine the relationship between CBF, CSF, and intracranial pressure in headaches assigned to low CSF pressure.
Highlights
According to the International Headache Society, headaches attributed to low cerebrospinal fluid (CSF) pressure are described as orthostatic headaches caused by spontaneous or secondary low CSF pressure or CSF leakages, usually accompanied by neck pain, tinnitus, changes in hearing, photophobia, and/or nausea
Due to several possible causes of headaches, they can be divided into categories: post-dural-puncture headaches (PDPH), occurring within five days of a lumbar puncture (LP); CSF fistula headaches, occurring after a procedure or trauma causing persistent cerebrospinal fluid leakage resulting in low intracranial pressure; and headaches attributed to spontaneous intracranial hypotension (SIH), caused by low CSF pressure of spontaneous origins [1]
The objective of this paper is to present a review with the aim of establishing the relationship between cerebral blood flow (CBF), CSF, and intracranial pressure (ICP) in headaches attributed to low CSF pressure
Summary
According to the International Headache Society, headaches attributed to low cerebrospinal fluid (CSF) pressure are described as orthostatic headaches caused by spontaneous or secondary low CSF pressure or CSF leakages, usually accompanied by neck pain, tinnitus, changes in hearing, photophobia, and/or nausea. Due to several possible causes of headaches, they can be divided into categories: post-dural-puncture headaches (PDPH), occurring within five days of a lumbar puncture (LP); CSF fistula headaches, occurring after a procedure or trauma causing persistent cerebrospinal fluid leakage resulting in low intracranial pressure; and headaches attributed to spontaneous intracranial hypotension (SIH), caused by low CSF pressure of spontaneous origins [1]. The objective of this paper is to present a review with the aim of establishing the relationship between CBF, CSF, and ICP in headaches attributed to low CSF pressure
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