These headaches can be tricky when it comes to diagnosis and management. Low CSF (cerebrospinal fluid) headache is usually accompanied by neck pain, ringing in the ears, changes in hearing, light sensitivity and/or nausea. There is usually a strong positional component as a triggering and relieving factor. It remits after normalization of CSF pressure or successful sealing of the CSF leak. With time, these accompanying symptoms may fade away and only an unremitting daily headache remains. On the other hand, high CSF pressure may be accompanied by very similar symptoms to low CSF pressure with the exception of visual blurriness, blind spots in vision, worsening with coughing , sneezing and bending over.
It takes considerable experience and expertise to come to the correct diagnosis and treatment of these CSF related headache disorders.