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Sudden severe headache is often encountered and can be caused by many diseases, ranging from the harmless to life threatening. While CT and MR scans are mainly used to rule out intracranial bleeding and intracranial masses, lumbar puncture is performed to diagnose infections. We describe a case of subarachnoid haemorrhage (SAH) which was invisible on both CT and MRI but it was detected by examination of the CSF.
A 56-year-old patient presented to our emergency department with a 3 week history of intense non-resolving frontal headache. His medical history was uneventful apart from two episodes of headache associated with flu-like symptoms and sinusitis. His family physician had started antibiotics assuming sinusitis. However, the pain had increased, sensitivity to light and noise developed, and he became severely incapacitated in his daily activities. The ear nose and throat specialist ordered a CT scan without contrast by which sinusitis was ruled out (the scan did not include the …
Competing interests None.
Patient consent Obtained.
Provenance and peer review Commissioned; externally peer reviewed.