Postcontrast Meningeal MR Enhancement Secondary to Intracranial Hypotension Caused by Lumbar Puncture

Intracranial hypotension, which is most commonly caused by lumbar puncture, can lead to intense meningeal enhancement, which resolves on its own once the intracranial hypotension has been corrected. The characteristic clinical presentation of severe postural headaches with a low opening CSF pressure on subsequent lumbar puncture and a history of prior dural puncture should alert one to the diagnosis, thus avoiding an extensive workup for carcinomatosis or infection.