Headache is a common problem in patients with cancer undergoing active treatment or in cancer survivors. However, severe orthostatic headache is less common and should be carefully differentiated. Spontaneous intracranial hypotension (SIH) is a rare and often misdiagnosed disorder. Neuroimaging is crucial for diagnosing and monitoring SIH. Awareness of SIH is essential because patients with SIH often suffer from severe impairment of quality of life and psychological distress before receiving a correct diagnosis and treatment. We present a case of a 66‑year‑old man who had squamous cell carcinoma of the tonsil, stage IV with multiple metastases, and was diagnosed with SIH during the period of palliative treatment.