Abstract
A 35-year-old man presented with fever, headache, and vomiting. Lumbar puncture showed low pressure (50 mm H2O), raised levels of protein (4.96 g/L) and white cell count (2,500; 85% polymorphs), and a glucose level of 1.61 mmol/L. MRI demonstrated diffuse leptomeningeal and pachymeningeal enhancement (figure, A), suggesting meningitis and intracranial hypotension due to spontaneous skull base CSF leaks, which were confirmed by CSF culture …
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