Meningeal Gadolinium Enhancement in Low‐pressure Headaches

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Abstract
Three patients with headaches in erect but not recumbent positions had barely measurable cerebrospinal fluid (CSF) pressures and aseptic but abnormal CSF findings with variable pleocytosis and elevated protein content. The CSF glucose level was normal and there were no blasts or malignant cells. Gadolinium‐enhanced magnetic resonance imaging (MRI) in all 3 showed diffuse meningeal enhancement. In 2, headaches and MRI abnormalities completely resolved spontaneously. The third patient, who had a prior ventriculoperitoneal shunt, improved after shunt revision.