Spinal CSF leaks: mimicker of primary headache disorder in a child.

Spontaneous intracranial hypotension (SIH) due to spinal cerebrospinal fluid (CSF) leaks is becoming increasingly recognized as a cause of headache in adults.1 A combination of minor trauma and developmentally ‘weak’ meninges has been considered to be responsible for some cases.1,2 There is also an association with autosomal dominant polycystic kidney disease, neurofibromatosis type 1, Marfan and the Ehlers-Danlos syndromes.1-3 The onset of symptoms is typically in the fourth or fifth decade of life, females being more affected than males. Childhood presentation in the absence of Marfan syndrome is rare,4 and the diagnosis can be challenging, as illustrated by our case report.