Low pressure headache typically occurs as a complication of dural puncture. 
"Spontaneous" low pressure headache is a relatively rare but under-recognised 
cause of intractable headache. Clinical suspicion of this condition warrants 
imaging of the brain to confirm the diagnosis; spinal imaging may be needed to 
identify the site of the leak. Epidural blood patching may be necessary to seal 
the leak - CT fluoroscopy may be helpful in delivering the patch directly to the 
site of the leak. Surgical intervention may be required in intractable cases. We 
describe a patient with spontaneous intracranial hypotension and review the 
clinical and radiological features of this syndrome.