Irie Jin, Shiga Kensuke
Emergency and Critical Care, Tsugaru Health Coop Kensei Hospital, Hirosaki, Japan.
Neurology, Matsushita Memorial Hospital, Moriguchi, Japan.
BMJ Case Rep. 2019 Aug 10;12(8):e229103. doi: 10.1136/bcr-2018-229103.
Orthostatic headache (OH) is a key symptom of spontaneous intracranial hypotension (SIH). However, there is no optimal history taking for OH. A 35-year-old man complained of headache that prevented him from performing routine physical activities, which was relieved on lying down. We initially considered migraine as the most likely diagnosis. However, detailed history taking revealed that his headache worsened on standing, and he was finally diagnosed with SIH. Headache relief on lying down is not a specific indicator of OH associated with SIH. Thus, with regard to headache history taking, we suggest it important to confirm headache aggravation on standing.
直立性头痛（OH）是自发性颅内低压（SIH）的关键症状。然而，目前尚无针对OH的最佳病史采集方法。一名35岁男性主诉头痛，这使他无法进行日常体育活动，躺下后头痛缓解。我们最初认为最可能的诊断是偏头痛。然而，详细的病史采集显示他站立时头痛加重，最终被诊断为SIH。躺下后头痛缓解并非与SIH相关的OH的特异性指标。因此，关于头痛病史的采集，我们建议确认站立时头痛加重很重要。
