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A 16-year-old boy presented with a 4-week history of sudden onset and progressively worsening occipital headache. Symptoms were exacerbated on sitting and standing, and initially alleviated with recumbency and on extensive neck flexion. There was no medical or familial history. He was a keen line skater, regularly executing back flips on a skating ramp. However, there was no history of trauma sustained preceding the onset of headache. …
Competing interests: None declared.