Abstract
A 26-year-old man had an appendectomy under spinal anesthesia. The prognosis of the operation was uneventful, however the patient suffered a post spinal headache after surgery. He was given a mixture of antipyretic analgesics (nonsteroidal anti-inflammatory drugs). After disappearance of the post spinal headache (12 days after the operation), he went on a one-day excursion to a high mountain (about 2, 500 meters high) by a vehicle. In the evening, he had a buzzing in his ears, vertigo and headache. Next day, he consulted a neurosurgeon. The cause of his headache was diagnosed as a low-pressure syndrome by findings of the computed tomogram and acute bilateral hearing disorder in the low-pitched sound by findings of audiogram. These symptoms were like those of Meniere's disease. Seven days after routine therapy for Meniere's disease, these symptoms gradually disappeared. Vertigo disappeared in the early phase, and then headache and buzzing also disappeared. The character of the headache changed from dull pain to head heaviness. It is well known that a cause of post-spinal headache is a decrease in the intracranial pressure and the dilatation of intracranial veins by leakage of cerebro-spinal fluid. The present symptoms were considered to be caused by the pressure difference due to rapid change in atmospheric pressure from low (the highland) to normal (the level ground).
