Spontaneous intracranial hypotension (SIH) is an increasingly recognized syndrome. Postural headache with typical findings on magnetic resonance imaging (MRI) are the key to diagnosis. Delay in diagnosing this condition may subject patients to unnecessary procedures and prolong morbidity. We describe a patient with SIH and outline the important clinical and radiographic features of this syndrome. Headache due to SIH is similar to headache occurring after lumbar puncture. Patients with postural headaches should have brain MRI before lumbar puncture. Meningeal abnormalities with typical clinical features are helpful in establishing the diagnosis. When correctly diagnosed, SIH management, in most cases, is easy and highly effective.
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