Paradoxical postural headaches in cerebrospinal fluid leaks

Bahram Mokri, A. J. Aksamit, J. L.D. Atkinson

Research output: Contribution to journalArticlepeer-review

38 Scopus citations


Two patients with cerebrospinal fluid (CSF) leak, one at the level of fourth thoracic spine and another with undetermined level of leak, presented with paradoxical postural headaches in that the headaches were present when in a horizontal position and resolved if the patients were upright. One patient improved spontaneously and the other responded to a targeted epidural blood patch. Paradoxical postural headache is yet another headache type that can be associated with CSF leak and CSF volume depletion. Its mechanism is uncertain, but it could be related to congestion and dilatation of cerebral venous sinuses and large veins.

Original languageEnglish (US)
Pages (from-to)883-887
Number of pages5
Issue number10
StatePublished - Oct 2004


  • Chiari malformation
  • MR myelography
  • Pachymeningeal enhancement
  • Postural headache
  • Spontaneous CSF leak

ASJC Scopus subject areas

  • Clinical Neurology


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