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An 87-year-old woman presented to the emergency department with an acute-onset severe global headache of 36 hours' duration, with greater occipital involvement than frontal involvement. She reported no recent trauma, prior sinus surgery or sinusitis, fevers, chills, neck stiffness, or photophobia, and she had no clinically relevant medical history. Physical examination showed that she was afebrile, alert, and oriented, with a supple neck. Her neurologic examination, including funduscopy and a leukocyte count, was normal. Computed tomography of the head and paranasal sinuses revealed pneumocephalus involving the anterior and middle cranial fossae (Panel A), without evidence of herniation. In addition, there . . . [Full Text of this Article] |
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