Spinal cerebrospinal fluid (CSF) leaks, the cause of Spontaneous Intracranial Hypotension (SIH), share many symptoms with Arachnoiditis and are often misunderstood or misdiagnosed. The hallmark sign is a positional headache that worsens when standing and eases when lying down, but symptoms like fatigue, brain fog, and nausea are also common. Awareness is essential for faster diagnosis and effective treatment options such as bedrest, epidural blood patches, or surgery.