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Clinical History: A 48-year-old female presents with a 5-day history of worsening orthostatic headache with photophobia and neck stiffness, visual disturbances and a normal neurological examination. She had a 6-month history of milder headaches prior, worse upon coughing. No significant trauma or surgical history. She underwent multiple ineffective blood patches with relapsing symptoms. She subsequently had a multi-level interlaminar decompression by neurosurgery which identified a dural defect at the thoracic level. She was treated with multi-level duragen placement and use of fibrin sealant resolving the underlying cause of her symptoms for which she was followed up by the Neurosurgical team., 48 years, female