Spontaneous intracranial hypotension (SIH) syndrome can be difficult to diagnose, and standard MRI techniques are not particularly effective at detecting the cerebrospinal fluid (CSF) leaks that characterize this condition. New research published in Neurology, however, indicates that spinal MRI with subtraction analysis might provide an effective, noninvasive means of detecting epidural CSF leakage in patients with SIH syndrome, and could even represent the first-line diagnostic approach in this setting.