Hi Sick and Tired, I understand your frustration! The symptoms of both high and low ICP are similar, and unfortunately, we are prone to both. Generally, from what patients have told me (there are a lot of Facebook groups dealing with this), most of us have high pressure, but because the pressure is high and the dura is weak, we can then LEAK, and suffer from LOW ICP. If the leak is repaired, then the patient usually returns to HIGH ICP. Crazy, huh? Before jumping to leaks as the cause of symptoms, I usually like to be sure Diamox is being prescribed and monitored correctly. I’ve seen every mistake in the book when doctors prescribe this. Diamox is something that most eye doctors excel with (especially optometrists, who don’t perform surgery — we handle much of the medicines, the surgeons — ophthalmologists — prefer to handle surgery). I have a CSF leak out of my nose, but still need to reduce my pressure. If the leak is in the spine, then the symptoms of LOW pressure are more of a problem. Sometimes they are most evident when the patient becomes vertical — but not always. Some day, our care, diagnosis and treatment will appear barbaric and archaic. We’re still working on improving the science, though… Ugh.