title: Intracranial hypotension causing headache and neck pain: a case study.
abstract: OBJECTIVE
  The purpose of this study is to discuss the presentation, examination, diagnosis, and treatment of a case of intracranial hypotension presenting to a chiropractic office as acute severe headache and neck pain.
  
  
  METHODS
  Flexion injury during a weight lift resulted in a severe postural headache and upper cervical spine pain in a 51-year-old man. The patient presented with unusual symptoms, but normal palpatory findings, and a lack of postural distortion.
  
  
  RESULTS
  Based on the history, symptoms, and examination findings, the patient was referred for an emergency medical evaluation. A diagnosis of intracranial hypotension was made, and a dural leak was confirmed by radioisotope cisternography. The patient made a complete recovery.
  
  
  CONCLUSIONS
  Intracranial hypotension can cause headache and neck pain that may appear to be musculoskeletal in nature. The key symptom is the orthostatic nature of the headache.
authors.affiliation: Bloomington, Ind 47404, USA. gaknutson@aol.com
authors.forename: Gary A
authors.initials: GA
authors.lastname: Knutson
mesh_terms: D001510:Bed Rest; D014695:Cerebral Ventriculography; D002684:Chiropractic; D004388:Dura Mater / Q000000981:diagnostic imaging / Q000293:injuries; D004636:Emergency Service, Hospital; D006261:Headache / Q000209:etiology*; D006801:Humans; D019585:Intracranial Hypotension / Q000150:complications* / Q000000981:diagnostic imaging / Q000209:etiology; D008297:Male; D008875:Middle Aged; D019547:Neck Pain / Q000209:etiology*; D011187:Posture; D012017:Referral and Consultation; D012421:Rupture / Q000150:complications / Q000000981:diagnostic imaging / Q000209:etiology; D013353:Subdural Effusion / Q000150:complications / Q000209:etiology / Q000628:therapy; D014891:Weight Lifting