A10.7 Head and/or neck pain attributed to orthostatic (postural) hypotension

Description:

Pain, mostly in the back of the neck but sometimes spreading upwards to the occipital region (“coathanger” distribution), attributed to postural hypotension and developing only in upright posture.

Diagnostic criteria:
  1. Headache fulfilling criterion C
  2. Orthostatic (postural) hypotension has been demonstrated
  3. Evidence of causation demonstrated by at least two of the following:
    1. headache develops exclusively during upright posture
    2. headache spontaneously improves in horizontal posture
    3. headache is mostly in the back of the neck, sometimes spreading upwards to the occipital region (“coathanger” distribution)
  4. Not better accounted for by another ICHD-3 diagnosis.
Comment:

When specifically asked, 75% of patients with orthostatic hypotension reported neck pain.