You are currently viewing Low CSF Volume Headache : Mnemonics

The Mnemonic “CSF LEAKS HEADACHE” can help you remember about Low CSF Volume Headache.

A low cerebrospinal fluid (CSF) volume headache, also called a low-pressure headache or a spontaneous intracranial hypotension headache, is a type of headache that happens when the CSF that covers the brain and spinal cord has less volume or pressure. The CSF cushions the brain and spinal cord to keep them from getting hurt.

Medical & nursing professionals will find this mnemonic very useful in their clinical rotations especially when they have to differentiate between different types of headache in patients.

CSF Volume Headache : Symptoms, Mechanism & Treatment

    • C – Chronic low CSF volume headache, positional pain
    • S – Spontaneous CSF leaks, post-LP headache
    • F – Fluid replacement with caffeine may provide temporary relief
    • L – Leak identification with imaging (MRI or CT myelography)
    • E – Early emptying of tracer may suggest a CSF leak
    • A – Autologous blood patch for identified leaks, curative
    • K – Known index events may cause leaks, such as LP or epidural injection
    • S – Surgery to decompress posterior fossa not indicated for Chiari malformations
    • H – Headache worsens with upright position, improves with recumbency
    • E – Enhancement pattern on MRI establishes diagnosis of CSF leak
    • A – Abdominal binder may be helpful for persistent pain
    • D – Diagnosis of postural orthostatic tachycardia syndrome needs consideration
    • A – IV caffeine and oral theophylline are alternative treatments
    • C – Cardiac screening before administering IV caffeine
    • H – Pain returns within minutes to an hour upon resuming an upright position
    • E – Most common cause is CSF leak following LP (lumbar puncture)



Low CSF Volume Headache : Initial Treatment

    • B – Bed rest (Initial treatment for low CSF volume headache)
    • I – IV caffeine (500 mg in 500 mL of saline administered over 2 h) for persistent pain
    • V – Verify arrhythmia with ECG before administration
    • C – Caffeine sparing further investigations due to safety and curative effects
    • A – Abdominal binder may be helpful if unsuccessful
    • B – Blood patch (autologous) usually curative if CSF leak can be identified
    • B – Blood patch also effective for post-LP headache, site empirically determined
    • A – Alternative treatment: oral theophylline for intractable headache

Mnemonic: BIV-CABBA 


Dr. Arin Nandi

Passionate About Medical Science & Helping Future Doctors Achieve Top Ranks In Medical Exams. He is professionally a dentist as well as a public health expert from JIPMER (1), (2)working in health department