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  • Title: Application of IHS criteria to headache attributed to spontaneous intracranial hypotension in a large population.
    Author: Mea E, Chiapparini L, Savoiardo M, Franzini A, Grimaldi D, Bussone G, Leone M.
    Journal: Cephalalgia; 2009 Apr; 29(4):418-22. PubMed ID: 19291244.
    Abstract:
    We applied the recent International Headache Society (IHS) criteria for headache related to spontaneous intracranial hypotension (SIH) to 90 consecutive patients with a final diagnosis of SIH confirmed by cerebral magnetic resonance imaging with contrast. Orthostatic headache (developing within 2 h of standing or sitting up) was present in 67 patients (75%) but appeared within 15 min after standing or sitting-as required by point A of the criteria-in only 53 (59%). Forty-four (49%) patients did not satisfy point A, including 22 (24%) with non-orthostatic headache and 14 (16%) with headache developing >or= 15 min after standing or sitting up; 80 (89%) did not satisfy point D. Only three (3%) patients had headache fully satisfying the IHS criteria. These findings indicate that the current IHS criteria do not capture most patients with SIH-associated headache. Excluding the requirement for response to epidural blood patch (criterion D) and considering headaches appearing within 2 h of sitting or standing up would capture more patients.
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