How do you evaluate and manage spontaneous intracranial hypotension?

This post looks at why we miss subarachnoid hemorrhage, specifically imaging and lumbar puncture.

A 38-year-old male with a history of injection drug use presents with one day of progressively worsening, pressure-like chest pain radiating to his back. He appears diaphoretic and in moderate distress. He has had new difficulty opening his mouth. On exam, he is tachycardic, diaphoretic, and in acute distress. He endorses tenderness throughout his thoraco-lumbar spine. Neurological evaluation demonstrated increased tone in all extremities. Skin exam reveals two abscesses on his upper extremities. An MRI of the spine is unremarkable. Reexamination reveals new spasmodic neck stiffening, jaw clenching and arching of his back. What is the likely diagnosis?

The EM Educator series looks at a patient with headache and vision changes.

Medical Malpractice Insights brings you a case of transverse myelitis.

This post covers the ins and outs of managing the critically ill patient with subarachnoid hemorrhage.

The emDOCs podcast covers PRES this week.

This post provides updates on the evaluation and management of transient ischemic attack in the ED.