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.
- Headache fulfilling criterion C
- Orthostatic (postural) hypotension has been demonstrated
- Evidence of causation demonstrated by at least two of the following:
- headache develops exclusively during upright posture
- headache spontaneously improves in horizontal posture
- headache is mostly in the back of the neck, sometimes spreading upwards to the occipital region (“coathanger” distribution)
- Not better accounted for by another ICHD-3 diagnosis.
When specifically asked, 75% of patients with orthostatic hypotension reported neck pain.