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Headache associated with vascular disease: migraine and stroke
Published in Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby, Headache in Clinical Practice, 2018
Stephen D. Silberstein, Richard B. Upton, Peter J. Goadsby
The headache of cerebellar hemorrhage is often acute and can be severe and maximal at onset, mimicking the headache of subarachnoid hemorrhage (SAH).86,87 Occipital location and associated neck stiffness are common.85,88 Orthostatic headache with aggravation by the upright position and alleviation by lying down can occur.86
Current perspectives on the recognition and diagnosis of low CSF pressure headache syndromes
Published in Expert Review of Neurotherapeutics, 2022
Nikolaos Giagkou, Ioanna Spanou, Dimos D. Mitsikostas
On the one hand, SIH must be differentiated from other causes of orthostatic headache. Postural orthostatic tachycardia syndrome is characterized by an abnormal increase in heart rate in the upright posture without orthostatic hypotension, which causes presyncopal symptoms or syncope [87,88]. In some patients, an orthostatic headache is also a prominent feature of the presenting complaint [87,88]. Orthostatic hypotension may also cause throbbing or dull pain in the shoulders, neck, and head when upright (‘coat-hunger headache’) [89]. Orthostatic headaches without CSF leak have also been reported after decompressive surgery for Chiari malformation, after large craniectomy, after sub-occipital craniectomy, or rarely with space-occupying lesions [5,90–92]. The headache associated with diabetes insipidus and cervicogenic headache might have a postural component [93].
Acute Enophthalmos After Lumbar Puncture in a Patient with Type 1 Neurofibromatosis Related Sphenoid Wing Dysplasia
Published in Neuro-Ophthalmology, 2022
Deanna Ingrassia Miano, Gregory Byrd, Rani Kattoula, Aye Thet, Ryan Adkins, Ryan Cosgrove, Samantha S. Johnson
It is difficult to conclude whether or not there was a small leak, which could have led to a CSF volume loss greater than the measured 13 mL. Orthostatic headache following LP can serve as a clinical tool when assessing for intracranial hypotension.14 Though our patient presented with a right-sided headache after the fluoroscopic-guided LP, it was unilateral and persistent regardless of posture, which can perhaps be attributed to the acutely distorted orbital anatomy. Unfortunately, the opening pressure were not measured during the LP, which could have helped in the assessment of this patient’s predisposition to intracranial hypotension. The remainder of the work-up demonstrated no other complications pathognomonic with CSF leakage.
Unusual gait disorders: a phenomenological approach and classification
Published in Expert Review of Neurotherapeutics, 2019
Vijayashankar Paramanandam, Karlo J. Lizarraga, Derrick Soh, Musleh Algarni, Mohammad Rohani, Alfonso Fasano
It is worth mentioning here that intracranial hypotension can also be associated with a gait disorder characterized by lower body parkinsonism (small, short steps) and instability. Usually, orthostatic headache is predominant and gait dysfunction is seen in the context of other movement disorders. However, we have recently observed isolated gait dysfunction in the absence of headache in two patients with intracranial hypotension [60]. Other conditions with abnormal ICP and/or CSF dynamics could also present with gait dysfunction, likely as part of a more complex neurological syndrome.