STUDY OBJECTIVE Clinical variables can reliably exclude a diagnosis of nontraumatic subarachnoid hemorrhage in patients with negative cranial computed tomography (CT) results. We externally validated 2 decision rules with 100% reported sensitivity for a diagnosis of subarachnoid hemorrhage, among patients undergoing lumbar puncture after a negative cranial CT result: (1) clinical rule: presence...

We report the case of a young patient with 36 weeks pregnancy, and an acute respiratory infection with severe bronchospasm, who developed an occipital headache and neck pain on the third day of inadvertent dural puncture during placement of combined epidural spinal anaesthesia for caesarian section. It was diagnosed as post-dural puncture headache until generalised tonic clonic seizures occurre...

Cerebrospinal fluid (CSF) leakage is known to cause orthostatic headache. Spontaneous CSF leakage occurs under several conditions, such as lumbar puncture, spinal surgery, and fracture of the spine. Intrasacral meningocele is an anomaly caused by an abnormal prolongation of the meninges in the sacral spinal canal. Typical symptoms of this anomaly are low back pain, bladder dysfunction, and scia...

Cerebrospinal fluid (CSF) leakage is known to cause orthostatic headache. Spontaneous CSF leakage occurs under several conditions, such as lumbar puncture, spinal surgery, and fracture of the spine. Intrasacral meningocele is an anomaly caused by an abnormal prolongation of the meninges in the sacral spinal canal. Typical symptoms of this anomaly are low back pain, bladder dysfunction, and scia...

A 43 year old man developed a sudden, severe headache while running in an orienteering competition. He continued to compete for a further 90 minutes before the worsening headache and the onset of vomiting forced him to seek medical help. He had moderate neck stiffness and no neurological deficit when admitted to hospital. Lumbar puncture showed uniformly bloodstained CSF, but CT scan and cerebr...

INTRODUCTION Postdural puncture headache (PDPH) is a known complication of diagnostic lumbar puncture. Multiple factors including needle size, type, and needle bevel orientation, have been postulated to contribute to the development of PDPH. The presentation of PDPH tends to have classic symptoms that include a postural headache, nausea, vomiting, tinnitus, and ocular disturbances. Conservative...