Dobrocky T, et al. - In this case-control study, researchers developed a probability score based on the most relevant brain magnetic resonance imaging (MRI) findings to evaluate the probability of spinal cerebrospinal fluid (CSF) leakage in spontaneous intracranial hypotension (SIH) patients. A total of 152 consecutive patients who were investigated for SIH at a single hospital department from February 2013 to October 2017. Findings suggested that this 9-point scoring system can help headache specialists objectively assess whether patients with spontaneous intracranial hypotension should be further investigated with invasive tests using intrathecal contrast media to identify a spinal cerebrospinal fluid leak that could be resolved with an epidural blood patch or microsurgical exploration. This score could be applied easily in routine clinical care and could lead to more standardized diagnostic and therapeutic pathways.