We also describe headache related to orthostatic hypotension, postural orthostatic tachycardia syndrome, and cerebrospinal fluid (CSF) hypotension which can be exacerbated by dehydration. In this review, we examine the current evidence detailing the association between dehydration and headache with attention to both primary and secondary headache disorders. The underlying mechanism for dehydration-related headache is probably variable and multi-factorial depending on the individual and other associated health conditions such as primary headache or autonomic disorders. In this case, restoration of intravascular volume could also abort headache. It has been suggested that water deficit in the body may result in dural venous stretching (Monro-Kelli doctrine) and thereby provoke headache. Despite the known relationship between dehydration, hypohydration, and headache, the pathophysiology is still not fully understood. Conditions that cause dehydration include but are not limited to medications (diuretics), diarrhea or emesis, sweat, cold, altitude, and lack of adequate water intake. Dehydration is the active process of losing body water when there is a water deficit in the body, it is referred to as hypohydration. However, this phenomenon can be deemed a secondary headache and considered under headache attributed to disorders of homeostasis. The International Classification of Headache Disorders 3rd edition (ICHD-3) does not define a specific headache syndrome related to dehydration.
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