One of the latest diagnoses that need to be considered when evaluating patients with persistent headache is spontaneous (postural) intracranial hypotension (SIH). The diagnosis can be clinched by magnetic resonance imaging (MRI) findings of subdural collections, meningeal enhancement and tonsillar descent. Cerebrospinal fluid leak has been postulated as the cause, and both medical and surgical treatment options have been documented. The treatment of choice is, however, an epidural blood patch. Here we discuss two cases of SIH treated successfully with epidural blood patch.
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