More than a headache—somatic and mental symptom burden in spontaneous intracranial hypotension before and after surgical treatment

IntroductionPatients with spontaneous intracranial hypotension (SIH) frequently present with several symptoms and impaired mental health. This study systematically investigates the somatic and mental symptom burden of SIH and the effect of surgical treatment.MethodsIn this single-center retrospective study, patients with surgical closure of a spinal cerebrospinal fluid leak between September 2022 and July 2023 completed the Somatic Symptom Scale (SSS-8), the Somatic Symptom Disorder – B Criteria Scale (SSD-12), and the Patient Health Questionnaire (PHQ-8) preoperatively and three and 6 months postoperatively.ResultsFifty-seven patients were included. All three scores showed clearly pathological values before surgery (SSS-8: 12 [IQR 6.5–16], SSD-12: 26 [IQR 19.5–33.5], PHQ-8: 11 [IQR 6.5–15]) representing a high somatic symptom burden and relevant current depression. After surgery, there was a significant and sustainable improvement (SSS-8: 8 [IQR 3–11.75], SSD-12: 12.5 [IQR 5–21.75], PHQ-8: 4.5 [IQR 2–9], p