Trigeminal Neuralgia After a Cerebrospinal Fluid Leak: A Case Report

Cerebrospinal fluid (CSF) leakage can be difficult to localize and may result in unexplained intracranial hypotension with intractable positional headache. Loss of CSF cushioning can cause brain sagging, leading to compression and traction of cranial nerves within the brain cisterns and mimicking Chiari malformation. This case report describes a patient presenting with trigeminal facial pain and positional headache who was ultimately diagnosed with a thoracic spinal CSF–venous fistula. Both headache and facial pain resolved following surgical intervention. This report highlights the importance of advanced diagnostic imaging and multidisciplinary management.