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The diagnostic triad of SIH consists of postural headache, low cerebrospinal fluid (CSF) pressure, and no history of lumbar puncture, trauma, infection, or surgery, and typical brain MRI findings [1]. In recent years, spinal MRI has begun to used to reveal the location of CSF leaks [2]. The headache of SIH typically resolves by conservative management such as hydration, analgesics and bed rest [1,2]. The epidural blood patch is considered the most effective treatment [3,4]. However, pharmacologic strategies may be considered before the blood patch.4 Corticosteroids, caffeine, and theophylline have also been reported to be effective [3,4].

Festooned Appearance and Corticosteroid Treatment in Spontaneous Intracranial Hypotension