Recommendations for the diagnosis and treatment of spontaneous intracranial hypotension.

Spontaneous intracranial hypotension (SIH) is a syndrome characterized by disabling orthostatic headache, resulting from a reduction in volume of cerebrospinal fluid (CSF) likely caused by a CSF leak. It mainly affects women at working age and is probably underdiagnosed. This protocol aims to present a proposal for a practical approach to the diagnosis and treatment of SIH. After a descriptive section of the clinical manifestations of SIH, we present a step-by-step model of action to confirm its diagnosis and treatment, considering different clinical scenarios. The aim is, therefore, to facilitate clinical decision-making through a systematized and individualized approach, aiming to best interest of the patient.