Diagnostic criteria of CSHa
| All Patients |
|---|
| A) Headache that worsens within 15 minutes after sitting or standing and improves after lying, with at least 1 of the following criteria: |
| 1) Neck stiffness, 2) tinnitus, 3) hypacusis, 4) photophobia, 5) nausea |
| Subgroup of patients with post-LP syndrome |
| B) Headache develops within 5 days after dural puncture |
| C) Headache resolves either |
| 1) Spontaneously within 1 week |
| 2) Within 48 hours after effective treatment of the spinal fluid leak |
| Subgroup of patients with idiopathic low CSF pressure syndrome |
| B) At least 1 of the following: |
| 1) CSF opening pressure <60 mm H2O in sitting position |
| 2) Evidence of CSF leakage on conventional myelography, CT myelography, or cisternography |
| 3) Evidence of low CSF pressure on MRI (eg, pachymeningeal enhancement) |
| C) No history of dural puncture or other cause of CSF fistula |
| D) Headache resolves after epidural blood patching |
| Subgroup of patients with shunt overdrainage |
| B) Previous shunt operation |
| C) Evidence of low CSF pressure on MRI (eg, pachymeningeal enhancement) |
a Adapted with permission from the Headache Classification Subcommittee of the International Headache Society.6