Case 1

A 71 year old man was admitted as an emergency with a two month history of progressive headache; coughing and straining exacerbated the pain but he had no nausea, vomiting, or disturbance of vision and his headache was not related to posture or time of day. He had a two year history of intermittent, non-specific headache, and an unenhanced cranial computed tomogram done 18 months previously had shown cortical atrophy only (figure (top)); no firm diagnosis had been reached at that time. He was taking warfarin for recurrent pulmonary emboli; six days before admission clotting tests showed an international normalised ratio of >6. On examination he had no abnormal physical signs; he had an erythrocyte sedimentation rate …