Abnormal lumbar isotope cisternography in an unusual case of spontaneous hypoliquorrheic headache

The unusual case of spontaneous hypoliquorrheic headache reported here was clinically identical to that originally described by Schaltenbrand. This is the first case to be studied by radioisotope cisternography, which showed that the cerebrospinal fluid flow was essentially normal. However, the radioactivity counts percent decreased rapidly, with simultaneous appearance of high isotope concentration in the urinary bladder. Scan images did not show cerebrospinal fluid (CSF) leakage at the puncture sites. Our data suggest that this postural headache syndrome is not caused by decreased CSF production, but by a very rapid absorption or unusual CSF leakage.