Intracranial hypotension causing headache and neck pain: a case study.
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.
Knutson
Gary A
GA
Bloomington, Ind 47404, USA. gaknutson@aol.com
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