Intracranial Hypotension

Intracranial hypotension results from reduced cerebrospinal fluid pressure, often due to spontaneous or iatrogenic CSF leaks. Clinical features include orthostatic headache, nausea, and neck stiffness. Pathophysiology involves decreased CSF volume causing traction on pain-sensitive structures and compensatory venous dilation. Diagnosis relies on MRI showing pachymeningeal enhancement and CSF pressure measurement. Management includes bed rest, hydration, epidural blood patch, and surgical repair when indicated; prognosis is generally favorable with appropriate intervention.