Overview
Introduction
A spinal dural tear lets cerebrospinal fluid escape, shrinking the protective cushion around the brain.
A spinal dural tear lets cerebrospinal fluid escape, shrinking the protective cushion around the brain. The resulting loss of volume pulls the brain downward; pain‑sensitive meningeal structures are stretched, producing the classic orthostatic headache. Recognising this pattern, ordering the appropriate imaging, and escalating therapy in a stepwise fashion are the keys to safe, effective care. The lesson proceeds from the physiologic meaning of the condition, through risk factors and diagnostic priorities, into the hierarchy of management, and finishes with a bedside scenario that ties the concepts together.