Application of IHS criteria to headache attributed to spontaneous intracranial hypotension in a large population

E. Mea*, L. Chiapparini, M. Savoiardo, A. Franzini, D. Grimaldi, G. Bussone, M. Leone

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

33 Scopus citations

Abstract

We applied the recent International Headache Society (IHS) criteria for headache related to spontaneous intracranial hypotension (SIH) to 90 consecutive patients with a final diagnosis of SIH confirmed by cerebral magnetic resonance imaging with contrast. Orthostatic headache (developing within 2 h of standing or sitting up) was present in 67 patients (75%) but appeared within 15 min after standing or sitting - as required by point A of the criteria - in only 53 (59%). Forty-four (49%) patients did not satisfy point A, including 22 (24%) with non-orthostatic headache and 14 (16%) with headache developing ≥ 15 min after standing or sitting up; 80 (89%) did not satisfy point D. Only three (3%) patients had headache fully satisfying the IHS criteria. These findings indicate that the current IHS criteria do not capture most patients with SIH-associated headache. Excluding the requirement for response to epidural blood patch (criterion D) and considering headaches appearing within 2 h of sitting or standing up would capture more patients.

Original languageEnglish (US)
Pages (from-to)418-422
Number of pages5
JournalCephalalgia
Volume29
Issue number4
DOIs
StatePublished - Apr 2009

Keywords

  • Classification
  • Headache
  • International Headache Society criteria
  • Orthostatic headache
  • Spontaneous intracranial hypotension

ASJC Scopus subject areas

  • Clinical Neurology

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