{"id":4323,"date":"2025-08-11T06:24:12","date_gmt":"2025-08-11T06:24:12","guid":{"rendered":"https:\/\/www.raffaellopagani-ccsvi.it\/?p=4323"},"modified":"2025-07-22T14:14:12","modified_gmt":"2025-07-22T14:14:12","slug":"orthostatic-headache-and-ccsvi","status":"publish","type":"post","link":"https:\/\/www.raffaellopagani-ccsvi.it\/en\/orthostatic-headache-and-ccsvi\/","title":{"rendered":"Orthostatic Headache and CCSVI: The Overlooked Hidden Link"},"content":{"rendered":"\t\t<div data-elementor-type=\"wp-post\" data-elementor-id=\"4323\" class=\"elementor elementor-4323 elementor-4179\">\n\t\t\t\t<div class=\"elementor-element elementor-element-f680ce2 e-flex e-con-boxed e-con e-parent\" data-id=\"f680ce2\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-5de97a7 elementor-widget elementor-widget-themeht-heading\" data-id=\"5de97a7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"themeht-heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\r\n        <div class=\"\">\r\n\r\n          <h2 class=\" \">When Headaches Change With Posture\n\n<\/h2>       \r\n\r\n        <\/div>\r\n\r\n        \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-6e1ebf4 elementor-widget elementor-widget-text-editor\" data-id=\"6e1ebf4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>As a physician, I have often encountered patients complaining of a very particular type of headache\u2014one that didn\u2019t fit the usual patterns. It wasn\u2019t the throbbing pain typical of migraine, nor was it the constant ache of tension-type headache. What stood out was a very specific detail: the headache would appear or significantly worsen <strong>when patients were standing or sitting<\/strong>, and would almost immediately improve as soon as <strong>they lay down<\/strong>.  <\/p><p>This seemingly minor postural detail is actually a <strong>significant clinical sign\u2014one<\/strong> that is often overlooked. Many of these patients had already consulted various specialists, tried medications, and undergone neurological tests, but still hadn\u2019t received a clear diagnosis. When orthostatic headache isn\u2019t linked to obvious causes such as cerebrospinal fluid hypotension, it often gets dismissed as \u201cnon-organic.\u201d Yet, if you look closer, there\u2019s a possible connection with <strong>CCSVI<\/strong> that deserves careful investigation.   <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-421c5bb elementor-widget elementor-widget-themeht-heading\" data-id=\"421c5bb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"themeht-heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\r\n        <div class=\"\">\r\n\r\n          <h2 class=\" \">What Is Orthostatic Headache?\n\n<\/h2>       \r\n\r\n        <\/div>\r\n\r\n        \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-babbd36 elementor-widget elementor-widget-text-editor\" data-id=\"babbd36\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Orthostatic headache is a type of headache that appears or worsens when you are upright. It is most commonly seen in situations where <strong>cerebrospinal fluid (CSF)<\/strong> is lost or absorbed too quickly, such as after a lumbar puncture, following trauma, or in rare conditions like <strong>spontaneous intracranial hypotension<\/strong>. <\/p><p>However, there is a group of patients who experience the same symptoms <strong>without any detectable abnormalities in their cerebrospinal fluid<\/strong>. There are no leaks, no malformations. So what\u2019s really going on? In these cases, I began to notice a striking pattern: many of these patients showed <strong>signs of impaired cerebral and cervical venous drainage\u2014consistent<\/strong> with a condition known as <strong>chronic cerebrospinal venous insufficiency<\/strong>, or CCSVI.   <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c83b7b4 elementor-widget elementor-widget-themeht-heading\" data-id=\"c83b7b4\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"themeht-heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\r\n        <div class=\"\">\r\n\r\n          <h2 class=\" \">CCSVI: When Veins Hinder Cerebral Outflow\n\n<\/h2>       \r\n\r\n        <\/div>\r\n\r\n        \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d55cea8 elementor-widget elementor-widget-text-editor\" data-id=\"d55cea8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>CCSVI is a condition in which blood struggles to flow properly from the brain back to the heart due to narrowing, <strong>compression, or abnormal reflux<\/strong> in the main veins responsible for cerebral drainage: the <strong>internal jugular veins, vertebral veins, and the azygos vein<\/strong>.<\/p><p>Under normal conditions, venous blood should flow freely and continuously. When this balance is disrupted, <strong>intracranial venous pressure can rise<\/strong>\u2014especially when standing\u2014because the veins responsible for drainage are partially or completely collapsed. <\/p><p>It\u2019s this very congestion that can trigger <strong>orthostatic headache<\/strong>: venous blood becomes \u201ctrapped\u201d in the skull, leading to increased pressure that stimulates pain receptors in the meninges and vascular structures of the brain. This mechanism can also explain <strong>other associated symptoms<\/strong>, such as brain fog, dizziness, trouble concentrating, or tinnitus. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-fce6989 elementor-widget elementor-widget-themeht-heading\" data-id=\"fce6989\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"themeht-heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\r\n        <div class=\"\">\r\n\r\n          <h2 class=\" \">How to Distinguish CCSVI-Related Headache\n\n<\/h2>       \r\n\r\n        <\/div>\r\n\r\n        \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-3ba3f31 elementor-widget elementor-widget-text-editor\" data-id=\"3ba3f31\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Over time, I\u2019ve learned to recognize some typical clinical features:<\/p><ul><li><strong>Posture is crucial<\/strong>: patients notice their headaches worsen when standing and feel relief once they lie down\u2014often within just a few minutes.<\/li><li><strong>The pain can be widespread, but it tends to localize<\/strong> in the occipital, cervical, or retro-orbital areas.<\/li><li>It\u2019s often accompanied by <strong>ear pressure<\/strong>, photophobia, nausea, or a sensation of \u201cfullness\u201d in the head.<\/li><li>Some patients report that even wearing a <strong>cervical collar<\/strong> or <strong>gentle neck traction<\/strong> can temporarily reduce the pain.<\/li><\/ul><p>A key point is that these patients <strong>don\u2019t respond to standard treatments<\/strong> for migraine or tension-type headache. Many have tried triptans, NSAIDs, antidepressants, or antiepileptic drugs\u2014without any significant improvement. This alone should suggest a \u201cnon-classical\u201d underlying cause.  <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ae72635 elementor-widget elementor-widget-themeht-heading\" data-id=\"ae72635\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"themeht-heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\r\n        <div class=\"\">\r\n\r\n          <h2 class=\" \">Supporting Evidence for the Connection\n\n<\/h2>       \r\n\r\n        <\/div>\r\n\r\n        \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4d42a14 elementor-widget elementor-widget-text-editor\" data-id=\"4d42a14\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The link between CCSVI and headache isn\u2019t just a clinical observation\u2014it\u2019s also supported by the scientific literature. Zamboni and other researchers have suggested that <strong>chronic venous stasis<\/strong> can lead to <strong>micro-hypoxia<\/strong>, oxidative stress, and <strong>neuroinflammation<\/strong>, all of which are known factors in triggering and sustaining pain perception. <\/p><p>Some studies have reported <strong>improvements in orthostatic headache following venous treatments<\/strong>, such as angioplasty or surgical decompression in cases of extrinsic compression (for example, Eagle syndrome or muscular impingement). In certain patients, simply improving nighttime posture or using cervical pillows has led to a significant reduction in the frequency and intensity of pain. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-b6766f8 elementor-widget elementor-widget-themeht-heading\" data-id=\"b6766f8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"themeht-heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\r\n        <div class=\"\">\r\n\r\n          <h2 class=\" \">Why It Often Goes Undiagnosed\n\n<\/h2>       \r\n\r\n        <\/div>\r\n\r\n        \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-7cfd29e elementor-widget elementor-widget-text-editor\" data-id=\"7cfd29e\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The major challenge is that headache caused by CCSVI <strong>is not yet officially recognized in international neurological classifications<\/strong>. As a result, it is often labeled as \u201cnonspecific headache\u201d or, even worse, as \u201cpsychogenic.\u201d <\/p><p>The lack of awareness among medical professionals who aren\u2019t specialized in cranio-cervical vascular disorders means <strong>that targeted tests are rarely requested<\/strong>. Yet, even a simple <strong>venous color Doppler ultrasound<\/strong>\u2014performed both standing and lying down\u2014can already provide some very clear clues. <\/p><p>When clinical suspicion is high and the patient has associated symptoms (such as blurred vision, dizziness, or mild cognitive changes), I recommend <strong>further investigations<\/strong> like venous MR imaging (MRV), CBCT, or selective venography.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-1f2ab16 elementor-widget elementor-widget-themeht-heading\" data-id=\"1f2ab16\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"themeht-heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\r\n        <div class=\"\">\r\n\r\n          <h2 class=\" \">Comparison Table: CCSVI-Related Headache vs. CSF Hypotension\n\n<\/h2>       \r\n\r\n        <\/div>\r\n\r\n        \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-87243d8 elementor-widget elementor-widget-html\" data-id=\"87243d8\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"html.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t<style>\r\n  .table-responsive {\r\n    width: 100%;\r\n    border-collapse: collapse;\r\n  }\r\n\r\n  .table-responsive th,\r\n  .table-responsive td {\r\n    border: 1px solid #ccc;\r\n    padding: 10px;\r\n    text-align: left;\r\n  }\r\n\r\n  .table-responsive thead {\r\n    background-color: #f5f5f5;\r\n  }\r\n\r\n  @media screen and (max-width: 768px) {\r\n    .table-responsive {\r\n      border: 0;\r\n    }\r\n\r\n    .table-responsive thead {\r\n      display: none;\r\n    }\r\n\r\n    .table-responsive tr {\r\n      margin-bottom: 20px;\r\n      display: block;\r\n      border: 1px solid #ccc;\r\n      padding: 10px;\r\n      background-color: #fff;\r\n    }\r\n\r\n    .table-responsive td {\r\n      display: block;\r\n      text-align: left;\r\n      font-size: 16px;\r\n      border: none;\r\n      position: relative;\r\n      padding-left: 0;\r\n    }\r\n\r\n    .table-responsive td::before {\r\n      content: attr(data-label);\r\n      font-weight: bold;\r\n      display: block;\r\n      margin-bottom: 5px;\r\n      color: #333;\r\n    }\r\n  }\r\n<\/style>\r\n\r\n<table class=\"table-responsive\">\r\n  <thead>\r\n    <tr>\r\n      <th>Feature<\/th>\r\n<th>CCSVI-related Headache<\/th>\r\n<th>Headache from CSF Hypotension<\/th>\r\n    <\/tr>\r\n  <\/thead>\r\n  <tbody>\r\n    <tr>\r\n      <td data-label=\"Caratteristica\">Onset<\/td>\r\n<td data-label=\"Cefalea da CCSVI\">Slow, gradual when upright<\/td>\r\n<td data-label=\"Cefalea da ipotensione liquorale\">Sudden, often upon getting out of bed<\/td>\r\n    <\/tr>\r\n    <tr>\r\n      <td data-label=\"Caratteristica\">Relieving Position<\/td>\r\n<td data-label=\"Cefalea da CCSVI\">Supine or with cervical traction<\/td>\r\n<td data-label=\"Cefalea da ipotensione liquorale\">Supine or Trendelenburg position<\/td>\r\n    <\/tr>\r\n    <tr>\r\n      <td data-label=\"Caratteristica\">Other Associated Symptoms<\/td>\r\n<td data-label=\"Cefalea da CCSVI\">Tinnitus, brain fog, blurred vision<\/td>\r\n<td data-label=\"Cefalea da ipotensione liquorale\">Nausea, tinnitus, double vision<\/td>\r\n    <\/tr>\r\n    <tr>\r\n      <td data-label=\"Caratteristica\">Common Causes<\/td>\r\n<td data-label=\"Cefalea da CCSVI\">Venous stenosis, compressions, reflux<\/td>\r\n<td data-label=\"Cefalea da ipotensione liquorale\">CSF leaks, lumbar punctures<\/td>\r\n    <\/tr>\r\n    <tr>\r\n      <td data-label=\"Caratteristica\">Instrumental Diagnosis<\/td>\r\n<td data-label=\"Cefalea da CCSVI\">Venous Doppler, MRV, venography<\/td>\r\n<td data-label=\"Cefalea da ipotensione liquorale\">Spinal MRI, cisternography<\/td>\r\n    <\/tr>\r\n    <tr>\r\n      <td data-label=\"Caratteristica\">Treatment<\/td>\r\n<td data-label=\"Cefalea da CCSVI\">Angioplasty, decompression, posture adjustment<\/td>\r\n<td data-label=\"Cefalea da ipotensione liquorale\">Rest, caffeine, blood patch<\/td>\r\n    <\/tr>\r\n  <\/tbody>\r\n<\/table>\r\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-c5d0fca elementor-widget elementor-widget-themeht-heading\" data-id=\"c5d0fca\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"themeht-heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\r\n        <div class=\"\">\r\n\r\n          <h2 class=\" \">What Options Are Available After Diagnosis<\/h2>       \r\n\r\n        <\/div>\r\n\r\n        \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-016fd04 elementor-widget elementor-widget-text-editor\" data-id=\"016fd04\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>There\u2019s no one-size-fits-all treatment path; it needs to be tailored to the specific cause of CCSVI:<\/p><ul><li>If <strong>venous stenosis<\/strong> is present, <strong>venous angioplasty<\/strong> can be considered at specialized centers.<\/li><li>In cases of <strong>mechanical compression<\/strong>, such as Eagle syndrome, surgical intervention is an option.<\/li><li>For less severe cases, or while waiting for more <strong>definitive treatment, postural adjustments, targeted manual therapy, the use of orthopedic collars<\/strong>, and lifestyle changes can all help manage symptoms.<\/li><\/ul><p>What matters most is <strong>not to overlook<\/strong> the vascular component\u2014because for many patients, this is often the key to understanding symptoms that otherwise seem \u201cinexplicable.\u201d<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-4e0b582 elementor-widget elementor-widget-themeht-heading\" data-id=\"4e0b582\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"themeht-heading.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\r\n        <div class=\"\">\r\n\r\n          <h2 class=\" \">\u2753 Frequently Asked Questions (FAQ)\n<\/h2>       \r\n\r\n        <\/div>\r\n\r\n        \t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-ba424a1 elementor-widget elementor-widget-n-accordion\" data-id=\"ba424a1\" data-element_type=\"widget\" data-e-type=\"widget\" data-settings=\"{&quot;default_state&quot;:&quot;expanded&quot;,&quot;max_items_expended&quot;:&quot;one&quot;,&quot;n_accordion_animation_duration&quot;:{&quot;unit&quot;:&quot;ms&quot;,&quot;size&quot;:400,&quot;sizes&quot;:[]}}\" data-widget_type=\"nested-accordion.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t<div class=\"e-n-accordion\" aria-label=\"Accordion. Open links with Enter or Space, close with Escape, and navigate with Arrow Keys\">\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1950\" class=\"e-n-accordion-item\" open>\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"1\" tabindex=\"0\" aria-expanded=\"true\" aria-controls=\"e-n-accordion-item-1950\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> How can I know if I have CCSVI? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1950\" class=\"elementor-element elementor-element-d6cc137 e-con-full e-flex e-con e-child\" data-id=\"d6cc137\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-3e780c9 elementor-widget elementor-widget-text-editor\" data-id=\"3e780c9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>The first step is to perform a venous color Doppler ultrasound of the neck, both lying down and sitting up, to assess blood flow in the jugular and vertebral veins. If there are any suspicious findings, more in-depth tests can follow. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1951\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"2\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1951\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Is CCSVI recognized as a cause of headache? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1951\" class=\"elementor-element elementor-element-029696d e-con-full e-flex e-con e-child\" data-id=\"029696d\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-72824fb elementor-widget elementor-widget-text-editor\" data-id=\"72824fb\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Not yet included in official classifications, but an increasing amount of clinical data and research points to a direct link between venous abnormalities and postural symptoms\u2014including orthostatic headache.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1952\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"3\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1952\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Is treatment always invasive? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1952\" class=\"elementor-element elementor-element-3e1ab5d e-con-full e-flex e-con e-child\" data-id=\"3e1ab5d\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t<div class=\"elementor-element elementor-element-eac9c94 elementor-widget elementor-widget-text-editor\" data-id=\"eac9c94\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>No. In some cases, targeted physiotherapy or simple postural changes are enough. Only in more severe cases are angioplasty or surgical decompression considered. <\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1953\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"4\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1953\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Do symptoms improve after treatment? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1953\" class=\"elementor-element elementor-element-d01edf3 e-flex e-con-boxed e-con e-child\" data-id=\"d01edf3\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-b4ba7d7 elementor-widget elementor-widget-text-editor\" data-id=\"b4ba7d7\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\tIn my experience, many patients with CCSVI and orthostatic headache report <strong>significant and lasting improvements<\/strong> after personalized treatment, whether conservative or interventional.\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t\t<details id=\"e-n-accordion-item-1954\" class=\"e-n-accordion-item\" >\n\t\t\t\t<summary class=\"e-n-accordion-item-title\" data-accordion-index=\"5\" tabindex=\"-1\" aria-expanded=\"false\" aria-controls=\"e-n-accordion-item-1954\" >\n\t\t\t\t\t<span class='e-n-accordion-item-title-header'><div class=\"e-n-accordion-item-title-text\"> Can I have CCSVI even if my MRI is normal? <\/div><\/span>\n\t\t\t\t\t\t\t<span class='e-n-accordion-item-title-icon'>\n\t\t\t<span class='e-opened' ><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-minus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h384c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t\t<span class='e-closed'><svg aria-hidden=\"true\" class=\"e-font-icon-svg e-fas-plus\" viewBox=\"0 0 448 512\" xmlns=\"http:\/\/www.w3.org\/2000\/svg\"><path d=\"M416 208H272V64c0-17.67-14.33-32-32-32h-32c-17.67 0-32 14.33-32 32v144H32c-17.67 0-32 14.33-32 32v32c0 17.67 14.33 32 32 32h144v144c0 17.67 14.33 32 32 32h32c17.67 0 32-14.33 32-32V304h144c17.67 0 32-14.33 32-32v-32c0-17.67-14.33-32-32-32z\"><\/path><\/svg><\/span>\n\t\t<\/span>\n\n\t\t\t\t\t\t<\/summary>\n\t\t\t\t<div role=\"region\" aria-labelledby=\"e-n-accordion-item-1954\" class=\"elementor-element elementor-element-455a715 e-flex e-con-boxed e-con e-child\" data-id=\"455a715\" data-element_type=\"container\" data-e-type=\"container\">\n\t\t\t\t\t<div class=\"e-con-inner\">\n\t\t\t\t<div class=\"elementor-element elementor-element-332fcc5 elementor-widget elementor-widget-text-editor\" data-id=\"332fcc5\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<p>Oh yes- CCSVI affects the extracranial venous system and often <strong>can\u2019t be detected on a standard brain MRI<\/strong>\u2014especially if the scan is performed only in the supine position.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/details>\n\t\t\t\t\t<\/div>\n\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"elementor-element elementor-element-d3e9cf9 elementor-widget elementor-widget-text-editor\" data-id=\"d3e9cf9\" data-element_type=\"widget\" data-e-type=\"widget\" data-widget_type=\"text-editor.default\">\n\t\t\t\t<div class=\"elementor-widget-container\">\n\t\t\t\t\t\t\t\t\t<h3>\ud83d\udce9 Want to find out if CCSVI is the cause of your headaches?<\/h3><p>If you\u2019ve been struggling with orthostatic headaches for a while and no one has given you real answers, I encourage you to consider a vascular cause. It\u2019s possible that your pain isn\u2019t due to a primary neurological problem, but <strong>rather to a mechanical issue with venous drainage<\/strong>. <\/p><p><a title=\"Contacts\" href=\"https:\/\/www.raffaellopagani-ccsvi.it\/en\/contacts-vascular-surgery-ccsvi\/\" target=\"_blank\" rel=\"noopener\"><span style=\"text-decoration: underline;\"><strong>Contact me for a specialist consultation.<\/strong><\/span><\/a> With a thorough medical history and targeted tests, we can determine whether CCSVI is playing a role in your case and how best to address it.<\/p>\t\t\t\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t\t\t<\/div>\n\t\t","protected":false},"excerpt":{"rendered":"<p>Do you get headaches that worsen when standing up? It could be CCSVI. Discover the connection between posture, venous drainage, and orthostatic headache.  <\/p>\n","protected":false},"author":1,"featured_media":4185,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[140],"tags":[704,170,109,563,502,120,649,290,706,346,437,708,700,171,703,701,292,709,143,707,699,705],"class_list":["post-4323","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ccsvi-en","tag-atypical-migraine","tag-brain-fog-en","tag-ccsvi-en","tag-cefalea-posturale","tag-cerebral-venous-drainage","tag-cerebrospinal-venous-insufficiency","tag-cervical-traction","tag-chronic-headache","tag-differential-diagnosis-of-headache","tag-eagle-syndrome","tag-intracranial-hypertension","tag-jugular-doppler","tag-neuroinflammation","tag-orthostatic-headache","tag-pain-that-improves-when-lying-down","tag-postural-headache","tag-tinnitus","tag-underdiagnosed-neurological-disorders","tag-venous-angioplasty","tag-venous-mr-imaging","tag-venous-reflux","tag-venous-stasis-syndrome"],"acf":[],"aioseo_notices":[],"aioseo_head":"\n\t\t<!-- All in One SEO 4.9.10 - aioseo.com -->\n\t<meta name=\"description\" content=\"Do you get headache that worsen when standing up? 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