The Role of Trendelenburg Positioning for the Acute Symptomatic Management of Spontaneous Intracranial Hypotension

Tony Zhang, Sara J. Hooshmand, Nathaniel P. Rogers, David O. Sohutskay, Michel Toledano, Derek W. Stitt, Ivan D. Carabenciov, Ajay A. Madhavan, Jeremy K. Cutsforth-Gregory, Rafid Mustafa, Department of Neurology, Mayo Clinic, Department of Radiology, Mayo Clinic College of Medicine

The Neurohospitalist

Published online on November 17, 2025

Abstract

The Neurohospitalist, Volume 16, Issue 3, Page 280-285, July 2026.
BackgroundSpontaneous intracranial hypotension (SIH) results from cerebrospinal fluid (CSF) leakage due to spinal dural tears or CSF–venous fistulas. Orthostatic headache is the hallmark presentation, though severe downward displacement of the brainstem ...