To clarify the clinical characteristics of definite and non-definite diagnosis groups in intracranial hypotension accompanied by trauma (IHAT), we undertook investigations of registered patients (n=23) prospectively. The results revealed the following features of IHAT: 1) definite diagnosis group, 4 cases; 2) they had long periods from injury to onset (5.5 ± 5.7 days), but these were markedly shorter than in the non-definite group; 3) 75% of definite cases showed typical postural headache; 4)

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... % of definite cases showed dural enhancement on Gd-MRI; 5) all 4 cases had confirmed CFS leakage based on imaging diagnosis with cervical lesions in 2 cases and cervical-thoracic lesions in 2 cases; and 6) good recovery was achieved in them by conservative therapy and blood patch, with a cure rate of 100%. These findings suggest that confirmed CFS leakage is indispensable for reaching definite diagnosis of IHAT.