A 'postspinal headache' associated with incidental intracranial pathology

Summary A 28-year-old woman developed symptoms of raised intracranial pressure associated with an obstructive hydrocephalus following a spinal anaesthetic administered for a Kiellands rotation forceps delivery. A diagnosis of an unverified pineal body tumour was made after computerised axial tomography scanning and the symptoms were effectively treated by the insertion of a ventriculo-peritoneal shunt. This unusual case demonstrates the importance of careful history taking and neurological examination where symptoms of postspinal headache persist.