Table 2:

Diagnostic criteria of CSH^a

All Patients
A) Headache that worsens within 15 minutes after sitting or standing and improves after lying, with at least 1 of the following criteria:
1) Neck stiffness, 2) tinnitus, 3) hypacusis, 4) photophobia, 5) nausea
Subgroup of patients with post-LP syndrome
B) Headache develops within 5 days after dural puncture
C) Headache resolves either
1) Spontaneously within 1 week
2) Within 48 hours after effective treatment of the spinal fluid leak
Subgroup of patients with idiopathic low CSF pressure syndrome
B) At least 1 of the following:
1) CSF opening pressure <60 mm H2O in sitting position
2) Evidence of CSF leakage on conventional myelography, CT myelography, or cisternography
3) Evidence of low CSF pressure on MRI (eg, pachymeningeal enhancement)
C) No history of dural puncture or other cause of CSF fistula
D) Headache resolves after epidural blood patching
Subgroup of patients with shunt overdrainage
B) Previous shunt operation
C) Evidence of low CSF pressure on MRI (eg, pachymeningeal enhancement)

^a Adapted with permission from the Headache Classification Subcommittee of the International Headache Society.⁶