Possible mechanisms of PDPH are :
- CSF hypotension can lead to an increase in meningeal venodilation and expansion of blood volume, resulting in a headache caused by sudden venous distention.
- CSF leak-related intracranial hypotension can result in the sagging of intracranial structures and stretch of sensory intracranial nerves, which can cause pain and cranial nerve palsies.
- PDPH-associated neck, back, and shoulder pain may be caused by the traction of the upper cervical nerves.
Risk factors for developing PDPH include:
- Young age
- Female gender
- Pregnancy
- Low body mass index
- Previous history of PDPH