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Cerebrospinal fluid (CSF) leakage is known to cause orthostatic headache. Spontaneous CSF leakage occurs under several conditions, such as lumbar puncture, spinal surgery, and fracture of the spine. Intrasacral meningocele is an anomaly caused by an abnormal prolongation of the meninges in the sacral spinal canal. Typical symptoms of this anomaly are low back pain, bladder dysfunction, and sciatica, possibly caused by tethered cord. We describe CSF leakage from an intrasacral meningocele without tethered cord syndrome, which caused severe orthostatic headache.
Case report
A 23 year old woman was admitted to hospital with the complaint of severe headache. She described a similar episode two years previously. There was no aura or trigger, nausea, vomiting, or fever. Non-steroidal anti-inflammatory drugs were not effective. By lying down she could get some relief from her splitting headache. Cranial magnetic resonance imaging (MRI) showed no abnormalities. On the first occasion, the headache …