Diagnostic Criteria for Headache Due to Spontaneous Intracranial Hypotension: A Perspective

Wouter I. Schievink*, David W. Dodick, Bahram Mokri, Stephen Silberstein, Marie-Germaine Bousser, Peter J. Goadsby

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

115 Citations (Scopus)


The clinical and radiographic manifestations of spontaneous intracranial hypotension are highly variable and many patients do not satisfy the 2004 International Classification of Headache Disorders criteria. We developed new diagnostic criteria for spontaneous intracranial hypotension based on cases we have seen reflecting the variable manifestations of the disorder. These criteria provide a basis for change when the classification criteria are next revised.

The diagnostic criteria consist of A, orthostatic headache; B, the presence of at least one of the following: low opening pressure (≤60 mm H2O), sustained improvement of symptoms after epidural blood patching, demonstration of an active spinal cerebrospinal fluid leak, cranial magnetic resonance imaging changes of intracranial hypotension (eg, brain sagging or pachymeningeal enhancement); C, no recent history of dural puncture; and D, not attributable to another disorder.
Original languageEnglish
Pages (from-to)1442-1444
Number of pages3
Issue number9
Publication statusPublished - Oct 2011


  • headache
  • intracranial hypotension
  • intracranial pressure
  • magnetic resonance imaging


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