Brief Answer:
Intracranial HYPOTENSION. Low CSF pressure headaches

Detailed Answer:
Good evening. I am a neurologist and would like to suggest that your symptoms are virtually classic for an entity known as spontaneous low CSF pressure headaches or INTRACRANIAL HYPOTENSION. You may have a leak of CSF fluid from your ventricular system located in the brain and spinal cord. What is happening is that as you come to the erect position gravity is pulling on the inner lining of this ventricular system which cannot withstand the pull because there's not enough fluid inside to hold it up. There's a leak somewhere or for some reason you are not producing enough through your choroid plexus which is essentially the factory for CSF fluid. This PULLING on the lining (the meninges) is what will cause you pain, headaches, and ultimately all the rest of your symptoms you are mentioning including nausea/vomiting, etc.

However, when you lie down...what happens? You eliminate the strong pull of gravity on the brain and ventricular system....there is minimal sagging of the meninges and fluid pressures more or less normalize since you are now supported under your body by a flat/firm surface. Your symptoms go away and everyone is happy.....UNTIL you stand up again.

You need to get an MRI of the brain. Not a CT scan...an MRI and you don't need contrast either....waste of money....just get the MRI of the brain. If you've got this as a diagnosis then, the radiologist will see CSF fluid TRACKING OUTSIDE the space of the ventricular system and everything will literally "light up like a Christmas Tree" and you'll have your diagnosis. If the MRI shows the problem I would not necessarily do an invasive diagnostic procedure such as a spinal tap because you could lose fluid from the CSF and you really can't afford to lose fluid...the symptoms will get worse plus other complications can occur such as spontaneous tearing of the meninges and this will cause many other really bad consequences.

Bottom line is you need to get to a neurologist who can send you for the testing like...yesterday and have this taken care....and it's pretty easy. They could search for the leak to be more precise as to where the breach is or they could simply inject a blood patch which is what I've always done. Some of the younger whipper snappers think that's the barbaric way of doing things....I simply tell them that I know how to use a stethoscope and I can spell OPHTHALMOLOGY and I'll bet they can't even do one of those things! I think just doing a blood patch without precisely localizing where the leak is located is perfectly acceptable and I've had tons of happy customers jump off the anesthesiologist's table when it's done and feel like kissing everyone in the OR....that's how dramatic and literally how quickly the problem can be solved when a blood patch is injected by an experienced operator.

Stop HEAVING, STRAINING, or doing anything else that will risk increasing intracranial pressure because you just might "squeeze" more CSF THROUGH THE BREACH IN YOUR MENINGES. You may wish to stay as much off your feet as possible until you get the problem solved. You'll feel more comfortable plus you won't risk spontaneous bleeds and other complications.

I hope these answers satisfactorily addresses your question. If so, may I ask your favor of a HIGH STAR RATING with some written feedback?

Also, if there are no other questions or comments, may I ask you CLOSE THE QUERY on your end so this question can be transacted and archived for further reference by colleagues as necessary?

Please direct more comments or inquiries to me in the future at:

bit.ly/drdariushsaghafi

I would be honored to answer you quickly and comprehensively.

Please keep me informed as to the outcome of your situation.

The query has required a total of 20 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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Brief Answer:
Never heard of a fatal case of intracranial hypotension

Detailed Answer:
I've never heard of a case of a patient succumbing to spontaneous CSF hypotension causing postural headache symptoms. However, you should get checked out in case this turns out to be intracranial hypotension since it can cause subdural hemorrhages and those are at the least "inconvenient" to have to recover from! The fact that it only happens a few times a month only says that it is destined to get more frequent if not treated. Reason I say that is because there was a time it was only happening once in awhile, right? Then, it started happening once a month then, after a few months it started happening once every couple of weeks (twice monthly) and now a "few times" a month....am I right? There was a time when it didn't happen at all, correct? So, you need to now pay attention to getting a diagnosis and fixing it (whatever the cause).

The footdrop is unrelated to the intracranial hypotension and headaches. If you'd like to discuss that topic I would ask that we close this thread first then, you may open a fresh series of questions.

I hope these answers satisfactorily addresses your question. If so, may I ask your favor of a HIGH STAR RATING with some written feedback?

Also, if there are no other questions or comments, may I ask you CLOSE THE QUERY on your end so this question can be transacted and archived for further reference by colleagues as necessary?

Please direct more comments or inquiries to me in the future at:

bit.ly/drdariushsaghafi

I would be honored to answer you quickly and comprehensively.

Please keep me informed as to the outcome of your situation.

The query has required a total of 37 minutes of physician specific time to read, research, and compile a return envoy to the patient.

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