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A 16-year-old boy with a 3-month history of intermittent postural headaches presented with sudden worsening headache after a game of soccer. The results of a neurological examination were unremarkable. Magnetic resonance imaging showed elongation of the midbrain, bilateral frontoparietal subdural haematomas (Figure, A), and a collection of fluid within the soft tissues overlying the lumbar spine (Figure, B). The cerebrospinal fluid (CSF) opening pressure on lumbar puncture was low (60 mmHg). Spontaneous intracranial hypotension was diagnosed, and the response to conservative treatment was good.
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©The Medical Journal of Australia 2008 www.mja.com.au PRINT ISSN: 0025-729X ONLINE ISSN: 1326-5377