Intracranial hypotension treatment

If the site of the spinal CSF leak can be identified, then options include:

Epidural blood patch, performed by an anesthesiologist pain management specialist.

Surgical repair of the defect.

Over-draining CSF shunts are managed by replacing the valve with one that drains less.

Lumboperitoneal shunts may have to be removed or ligated.

Postural headache due to intracranial hypotension (true overshunting) is usually self limited, however, if symptoms persist after = 3 days of bed rest and analgesics and a trial with a tight abdominal binder, the valve should be checked for proper closing pressure.If it is low, replace with a higher pressure valve. If it is not low, an antisiphon device alone or together with a higher pressure valve may be needed ¹⁾.