Refractory orthostatic headache: A case report and literature review Wu CH, Yang FC, Hsu YC, Chang PY, - J Med Sci

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Refractory orthostatic headache: A case report and literature review Chan-Hsu Wu¹, Fu-Chi Yang², Yi-Chih Hsu³, Ping-Ying Chang⁴ ¹ Department of Internal Medicine, Hualien Armed Forces General Hospital, Hualien, Taiwan, R.O.C, Taiwan ² Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan ³ Department of Radiology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan ⁴ Division of Hematology/Oncology, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan Correspondence Address: Ping-Ying Chang, Division of Hematology/Oncology, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei 11490 Taiwan Source of Support: None, Conflict of Interest: None DOI: 10.4103/jmedsci.jmedsci_230_22

Headache is a common problem in patients with cancer undergoing active treatment or in cancer survivors. However, severe orthostatic headache is less common and should be carefully differentiated. Spontaneous intracranial hypotension (SIH) is a rare and often misdiagnosed disorder. Neuroimaging is crucial for diagnosing and monitoring SIH. Awareness of SIH is essential because patients with SIH often suffer from severe impairment of quality of life and psychological distress before receiving a correct diagnosis and treatment. We present a case of a 66-year-old man who had squamous cell carcinoma of the tonsil, stage IV with multiple metastases, and was diagnosed with SIH during the period of palliative treatment.

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