Clinical Research Directory

Inclusion Criteria: * Daily headache from onset lasting \> 3 months. * Headache described as pressure sensation. * Headache worsened in the Trendelenburg position. * Exposed to CSF pressure/volume lowering medications. * Tried 2 of 4 unless contraindications: acetazolamide, methazolamide, indomethacin SR or spironolactone) or CSF volume removal via LP with positive or neutral response. * Failed at least 3 typical headache preventative medications from different classes-antidepressants, antiepileptic, blood pressure medications. * MRI demonstrates that Nutcracker physiology is present. * Decreased SMA angle, renal vein narrowing, decreased AMD. * Retrograde lumbar vein flow and early EVP enhancement. * Ability to understand study procedures and to comply with them for the entire length of the study. * Negative pregnancy test. Exclusion Criteria: * Evidence of disc edema. * Positive urinalysis for hematuria or proteinuria. * Abnormal CBC or CMP. * MRI, MRA head and neck and MR venogram with a possible secondary causes of headache including space occupying lesions, Chiari malformation, cerebral vein thrombosis, hydrocephalus, dissection, aneurysm etc.