Lumbar Vein Embolization for Chronic Headaches With Nutcracker Physiology

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.