What is Intracranial Hypotension?

Intracranial hypotension is a medical condition characterized by a drop in pressure inside the brain cavity. This is most frequently caused by a leak of the cerebrospinal fluid, which surrounds the brain and spinal cord. The most common symptom of intracranial hypotension is the development of a severe headache, which may be accompanied by nausea, neck stiffness, or a sensitivity to light. In some cases, the cerebrospinal fluid may leak from the nose or ears. Treatment for intracranial hypotension may include bed rest, increased fluid intake, and the use of over-the-counter or prescription medications. In severe cases, surgical intervention may become necessary.

There are a variety of potential causes of intracranial hypotension, including head injury or surgery involving the brain or spinal column. Certain medical tests, such as a lumbar puncture, may also cause a fluid leak. An epidural tube placed in the spinal column for anesthesia or medication delivery is another potential cause of intracranial hypotension. In some instances, the exact cause for the condition cannot be found.

When intracranial hypotension is suspected, a variety of medical tests may be performed in order to confirm the diagnosis. A lumbar puncture involves the use of a needle that is placed into the spinal column to draw out a sample of the cerebrospinal fluid for testing. An MRI or CT scan may also be performed to check for a fluid leak.

In many cases of intracranial hypotension, medical intervention is not necessary. The patient may be advised to stay in bed until symptoms subside. During this time, increased fluid intake is often recommended. Beverages containing caffeine may help to alleviate the headache associated with a cerebrospinal fluid leak. Over-the-counter or prescription pain relievers may help to reduce some of the more painful symptoms.

If symptoms persist longer than a few days, medical intervention may become necessary. A procedure known as a blood patch may be needed to block the hole that is causing the leak. In more serious cases, a more invasive surgical procedure may be needed in order to stop the leak, although this is rarely necessary.

Most cases of intracranial hypotension resolve on their own with no medical intervention and no lasting negative effects on the overall health of the patient. On rare occasions, complications may develop that require immediate medical attention. A doctor should be notified right away if the headache significantly intensifies when sitting up or if a clear fluid begins to drain from the nose or ears.