A 21-year-old male US Navy search and rescue swimmer presented with a 1-day history of acute onset headache and left eye swelling. He denied any trauma but reported blowing his nose in the shower prior to the onset. The patient reported 2 similar headache episodes without eye swelling 3 months prior. The first was also triggered by blowing his nose, and the second occurred while exercising. Both previous headaches resolved over 2 days and were associated with a self-described audible “water trickling” sound in the left side of his head. The patient denied any weakness, paresthesias, or altered mental status.
Mikals SJ, Capra GG, Stewart AE. Acute Onset Headache and Left Eye Swelling. JAMA Otolaryngol Head Neck Surg. 2013;139(8):847-848. doi:10.1001/jamaoto.2013.3837