Pressure headache is caused by an internal cerebrospinal fluid (CSF) leak in the brain. The CSF flows around the brain and cushions it, so the loss of this fluid reduces pressure around the brain, stretching the meninges and nerves lining the brain, which then causes pain. Determining the underlying cause of your low pressure is important, and with testing at the Diamond Headache Clinic, our doctors can determine the source of your pain: spontaneous intracranial hypotension (low pressure); cerebrospinal fluid (CSF) leakage due to surgery, post-dural puncture from a lumbar tap or spinal anesthesia; a cyst or tear in one of the layers of tissues (meninges) that cover the spinal cord; or cerebrospinal fluid fistula. MRIs and CT scans are required to diagnose this condition and determine its exact cause and the location of the problem.
What Are the Symptoms of Pressure Headache?
Common symptoms may include:
- Intensely painful headache that is relieved by lying down
- Nausea and vomiting
- Vertigo, dizziness or unsteadiness
- Altered hearing
- Neck stiffness and pain
How Is Pressure Headache Diagnosed?
When you come to the Diamond Headache Clinic, you undergo a complete examination, including a thorough medical history and physical checkup. To treat this condition, determining the cause is vital. Your physician will likely order diagnostic tests, such as brain and spinal imaging, lumbar puncture or CSF analysis, to rule out other serious conditions, confirm the diagnosis and/or pinpoint the site of a CSF leak.
What Is the Recommended Pressure Headache Treatment?
Most patients with intracranial hypotension experience spontaneous improvement. Symptoms often subside following bed rest, oral intake of fluids, caffeine consumption and time. If symptoms continue, immediate treatment with epidural blood patching may be necessary. In this procedure, a small amount of the patient’s blood is injected into the space between the spine and the meninges in the lower back. This replaces the volume lost from CSF leakage, slowing the leakage of cerebrospinal fluid, regardless of where the leak is. If symptoms recur after treatment, your Diamond Headache Clinic physician will determine why the cause of your headache condition persists and/or find leakage sites that were undetected previously, and thus left untreated. However, surgery to repair a leak is rarely required.