Trendelenburg position: a tool to screen for the presence of a low CSF pressure syndrome in daily headache patients.

Objective: To test the hypothesis that the Trendelenburg position is an accurate screening investigation for the presence of a low cerebrospinal fluid (CSF) pressure syndrome in patients with daily headache.

Background: The Trendelenburg position causes a rapid increase in intracranial CSF pressure. In a patient with a known CSF leak who overtime had less improvement in the supine position, being placed in Trendelenburg rapidly alleviated her daily headache.

Pure menstrual cluster headache.

The influence of the menstrual cycle on female cluster headache is not well documented in the literature. A case patient is presented who had cluster headaches only during her menstrual cycles. This appears to be the first ever reported case of pure menstrual cluster headache.

Elevation of CSF tumor necrosis factor alpha levels in new daily persistent headache and treatment refractory chronic migraine.

Objective: To determine if patients with new daily persistent headache (NDPH) have elevated levels of tumor necrosis factor alpha (TNF alpha) in the CSF.

Background: NDPH is considered one of the most treatment resistant of all headache syndromes. This reflects a lack of understanding of its pathogenesis.