Orthostatic headache

Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
Founder, WikiMD Wellnesspedia &
W8MD medical weight loss NYC and sleep center NYC

Orthostatic headache
Synonyms	N/A
Pronounce	N/A
Specialty	N/A
Symptoms	Headache that worsens when standing or sitting upright
Complications	N/A
Onset	Sudden or gradual
Duration	Varies, often persistent
Types	N/A
Causes	Cerebrospinal fluid leak, Postural orthostatic tachycardia syndrome
Risks	Spinal tap, Trauma, Connective tissue disorders
Diagnosis	Clinical evaluation, MRI, CT myelography
Differential diagnosis	Migraine, Tension headache, Cluster headache
Prevention	N/A
Treatment	Bed rest, Caffeine, Epidural blood patch
Medication	N/A
Prognosis	Varies, often good with treatment
Frequency	Rare
Deaths	N/A

Orthostatic headache is a medical condition characterized by a headache that occurs when a person stands up and improves when they lie down. This condition is often associated with low cerebrospinal fluid (CSF) pressure, also known as spontaneous intracranial hypotension or SIH.

Symptoms

The primary symptom of an orthostatic headache is a headache that worsens upon standing and improves upon lying down. Other symptoms may include nausea, vomiting, neck pain, tinnitus, changes in hearing, and dizziness.

Causes

Orthostatic headaches are most commonly caused by a decrease in CSF pressure. This can occur due to a spontaneous CSF leak, which can occur without a known cause, or due to a traumatic event, such as a lumbar puncture.

Diagnosis

Diagnosis of orthostatic headache involves a thorough medical history and physical examination. Additional tests may include a magnetic resonance imaging (MRI) scan, a computed tomography (CT) scan, or a lumbar puncture to measure CSF pressure.

Treatment

Treatment for orthostatic headache depends on the underlying cause. If a CSF leak is identified, treatment may involve bed rest, hydration, and caffeine. In some cases, a procedure known as an epidural blood patch may be performed to seal the leak. If no leak is identified, treatment may involve medications to increase CSF production or to reduce pain.

See also

• Headache
• Migraine
• Tension headache
• Cluster headache

References

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