| Objective: The purpose of this study is to discuss the presentation, examination, diagnosis, and treatment of a case of intracranial hypotension presenting to a chiropractic office as acute severe headache and neck pain.
Clinical Features: Flexion injury during a weight lift resulted in a severe postural headache and upper cervical spine pain in a 51-year-old man. The patient presented with unusual symptoms, but normal palpatory findings, and a lack of postural distortion.
Intervention and Outcome: Based on the history, symptoms, and examination findings, the patient was referred for an emergency medical evaluation. A diagnosis of intracranial hypotension was made, and a dural leak was confirmed by radioisotope cisternography. The patient made a complete recovery.
Conclusions: Intracranial hypotension can cause headache and neck pain that may appear to be musculoskeletal in nature. The key symptom is the orthostatic nature of the headache. This abstract is reproduced with the permission of the publisher. Full text is available by subscription.
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