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Spontaneous cerebrospinal fluid (CSF) leak has been called “spontaneous intracranial hypotension,” emphasizing the intracranial symptoms and imaging findings. We present a patient with spontaneous CSF leak whose initial spinal magnetic resonance imaging (MRI) findings were thought to represent epidural tumor or infection. Subsequent MRI examinations showed an improvement of both intracranial and spinal CSF hypotension findings coinciding with clinical symptom resolution. We propose the term “spontaneous craniospinal hypotension” to better emphasize this syndrome's unifying intracranial and spinal pathophysiology and imaging findings. J. Magn. Reson. Imaging 2005. © 2005 Wiley-Liss, Inc.