Definition
CSF loss syndrome is an increasingly common disorder, which is mainly characterized by a so-called orthostatic headache. It is characterized by the fact that the pain increases significantly when standing, but becomes much milder or disappears completely when lying down. The cause of this symptomatology is the loss of cerebrospinal fluid, which causes irritation of the meninges.
There are many different other names for this disease such as CSF hypotension syndrome, hypoliquorrhea, spontaneous intracranial hypotension, etc. which bring different aspects of the disease into focus. The frequency of the disease is stated to be 5 out of 100,000 newly diagnosed patients and is therefore not as rare as many physicians assume. On average, women are affected twice as often as men.
The symptoms
The leading symptom of CSF loss syndrome is the so-called orthostatic headache, which is characterized by a worsening of pain when standing. It occurs, albeit with varying intensity, in all patients during the course of the disease. The intensity of this pain ranges from a slight to moderate pulling in the neck to the most severe travelling headache.
In addition to the pain, other symptoms may occur, depending on the severity of the disease. These include nausea, dizziness, sensitivity to light and noise, but also more serious neurological deficits such as impaired vision or hearing impairment. If there is no rapid therapy for cerebrospinal fluid loss, it can ultimately lead to a loss of consciousness.
The headaches that occur in the context of CSF loss syndrome are described as orthostatic and thus show a dependence on the position of the body. While there is almost no discomfort when lying down, the intensity of the pain increases significantly when standing or sitting. This phenomenon is due to the increased loss of cerebrospinal fluid during standing upright.
Since the brain and spinal cord normally “swim” in this cerebrospinal fluid, a loss of this fluid causes the tissue to sink. However, since the meninges are fixed to bony structures, a traction force is exerted, which is perceived as a severe headache. The pain usually affects the entire head and often spreads to the neck.
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