Spontaneous intracranial hypotension is a syndrome that occurs from a spinal cerebrospinal fluid leak, meaning a leak of CSF from a defect in the dura around the spinal cord. Symptoms often include:
- Headache, especially in the back of the head, that worsens upon standing, or a headache that’s triggered by coughing, sneezing, or exertion
- Pain in the neck or shoulders
- Dizziness/vertigo
-
Pulsatile tinnitus (ringing or whooshing in ear)
- Hearing loss
- Nausea
- Visual disturbances
- Changes in memory, thinking, or behavior (brain fog)
Since some of the symptoms of a CSF leak are non-specific and may be caused by other conditions, it’s important to seek medical care to get an accurate diagnosis.
Once the presence and location of a spinal CSF leak have been confirmed, the neuro-imaging specialist may perform an epidural blood patch or fibrin patch procedure and/or refer the patient to a neurosurgeon with expertise in closing these leaks.

Three types of spinal CSF leaks. Type 1: a bone spur creates a tear in the dura. Type 2: a rupture of an outpouching of dura surrounding a nerve root. Type 3: rupture of the dura with leakage of CSF into an adjacent blood vessel (CSF-venous fistula).
Our Care Team
- Chief of Neurological Surgery, NewYork-Presbyterian Queens
- Co-director, Weill Cornell Medicine CSF Leak Program
- Director, Spine Imaging and Interventions
- Co-director, Weill Cornell Medicine CSF Leak Program
Reviewed by: Gayle Salama, MD, and John Park, MD, PhD
Last reviewed/last updated: February 2023
Illustration by Thom Graves, CMI