A 29-year-old woman, for three weeks, develops headache about fifteen minutes after getting out of bed, and it eases within half an hour if she lies down. She also has neck pain and a rushing sound. She gave birth two months ago and had an epidural. Fundoscopy at this visit is normal.
Which mechanism belongs on the table first?
A classic orthostatic headache raises low CSF pressure, and an epidural is an important clue to a leak. Normal fundi argue against high pressure. They do not mean the pain is trivial.
Around childbirth, cerebral venous thrombosis also stays in mind, especially if the pain is no longer purely postural or a neurological sign appears. Imaging steps and sealing a leak are specialist decisions.
This is a teaching vignette and refers to no identifiable patient. These pages are written for health professionals. They do not replace a history, examination, or clinical judgment. Treatment is decided for each patient individually.