Spontaneous Intracranial Hypotension Associated with Postural Tachycardia Syndrome

Intern Med. 2019 Sep 1;58(17):2569-2571. doi: 10.2169/internalmedicine.2587-18. Epub 2019 May 22.

Abstract

Postural tachycardia syndrome (POTS) can cause orthostatic headache. However, it is difficult to differentiate POTS from spontaneous intracranial hypotension (SIH) caused by cerebrospinal fluid (CSF) leaks. We herein report a 53-year-old woman who presented with SIH associated with POTS. A cervicothoracic and lumbar epidural blood patch rapidly improved not only the headache but also the orthostatic tachycardia, suggesting POTS secondary to SIH. This case suggests that a CSF leak can cause secondary POTS. Therefore, POTS should be considered in patients with orthostatic headaches, even in the presence of a CSF leak.

Keywords: cerebrospinal fluid-blood gradient; orthostatic headache; postural tachycardia syndrome; spontaneous intracranial hypotension.

Publication types

  • Case Reports

MeSH terms

  • Blood Patch, Epidural
  • Cerebrospinal Fluid Leak / complications
  • Female
  • Headache / etiology
  • Headache / therapy
  • Humans
  • Intracranial Hypotension / etiology*
  • Middle Aged
  • Postural Orthostatic Tachycardia Syndrome / complications*
  • Postural Orthostatic Tachycardia Syndrome / etiology
  • Postural Orthostatic Tachycardia Syndrome / therapy