Can Ramadan fasting cause relapse and aggravation of spontaneous intracranial hypotension?

Chronic headache is known to be aggravated by fasting and fasting even triggers headache among those not suffering from chronic headache. Headache is also aggravated during Ramadan in which Muslim people do not eat, drink, or smoke from dawn to sunset for about one month in a year. Headaches mainly increase in people who are prone to headaches like migraine sufferers. As far as we know there are no reports on specific headache syndromes pointing to precipitating factor of fasting. In this report, we present a 32-year-old man diagnosed with spontaneous intracranial hypotension, treated by conservative means and who relapsed after fasting during Ramadan. We aim to discuss the possible underlying mechanisms of precipitation of orthostatic headache during fasting.