Treatment of orthostatic headache without intracranial hypotension: a case report.

Abstract

INTRODUCTION:

Orthostatic headache is very suggestive of intracranial hypotension. It has a good prognosis as it usually responds to conservative treatment or epidural blood patches.

CASE REPORT:

A 36-year-old female presented with severe and prolonged orthostatic headache starting after a seizure. No stigma of intracranial hypotension was detected on brain MRI, and intracranial pressure was within normal range. No imaging evidence of a fistula was found. She was refractory to symptomatic treatment including five epidural blood patches. Progressive improvement occurred simultaneously to the introduction of vitamin A supplementation.

DISCUSSION:

A series of six similar patients is discussed, in which five patients remained severely symptomatic and workdisabled at an average follow-up of four years. It is proposed that the pathophysiological mechanism producing orthostatic headache might not be dependent on intracranial hypotension and could respond to vitamin A.

• Authors: Raquel Gil-Gouveia
• Journal: Cephalalgia : an international journal of headache (Cephalalgia) Vol. 33 Issue 11 Pg. 948-50 (Aug 2013) ISSN: 1468-2982 [Electronic] England
• PMID: 23564210 (Publication Type: Case Reports, Journal Article)

Chemical References

• Vitamins
• Vitamin A

Topics

• Adult
• Blood Patch, Epidural
• Fatigue Syndrome, Chronic (complications)
• Female
• Headache (complications, drug therapy)
• Humans
• Intracranial Hypotension
• Overweight (complications)
• Seizures (complications)
• Vitamin A (therapeutic use)
• Vitamins (therapeutic use)