What is low CSF pressure headache? Low cerebrospinal fluid (CSF) pressure headache is caused by an internal spinal fluid leak and may range from obvious and disabling to subtle and nagging. The brain normally sits inside a bag filled with spinal fluid that extends down from the skull into the spine. The bag consists of membranes called the meninges (as in meningitis). The fluid helps to circulate waste products out of the brain and provides cushioning and support. When the pressure of this fluid is too low typically when there is a small leak somewhere in the meninges — the brain may sag downward when the patient is upright, stretching the meninges and nerves lining the brain and causing pain. What are the symptoms of low pressure headaches? The classic symptom is a headache that becomes severe when the patient is upright and quickly disappears when the patient is lying flat. So, the headaches are typically absent first thing in the morning, and start or worsen shortly after getting out of bed. The pain is often worse at the back of the head, and may be accompanied by some neck discomfort and nausea. Rarely there are more serious neurological symptoms caused by stretching nerves or the downward displacement of the brain.
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