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William A. Nosik, M.D.
JAMA. 1955;157(13):1110-1111. doi:10.1001/jama.1955.02950300038008.
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The syndrome of intracranial hypotension is well known to anyone experienced with the lumbar puncture. This syndrome, which occurs within 12 to 24 hours after a puncture, may include nausea, vomiting, stiffness of the neck, and occasional fever of variable degree; it may progress even to the point of extreme prostration; yet the particularly noteworthy symptom is headache. A salient characteristic of this headache is its complete disappearance when the patient lies down and its prompt reappearance when he resumes the sitting position. This headache, which ranges the entire gamut of severity, is most frequently localized in the fronto-occipital area and is described as being of a thumping, throbbing type. Repeated observations tend to validate the premise that the headache is due to leakage of spinal fluid through a needle hole in the dura, since a second puncture usually reveals a low pressure. Mixter has observed such a spinal fluid


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