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Figure 2: Magnetic resonance imaging with contrast and detailed cerebral and cervical vascular imaging before doing the lumbar puncture will help rule out/confirm the newer entities that can present as "thunderclap headache." As these cannot be confirmed through cerebrospinal fluid examination, the suggestion is to move from "lumbar puncture first" to "lumbar puncture last"

Figure 2: Magnetic resonance imaging with contrast and detailed cerebral and cervical vascular imaging before doing the lumbar puncture will help rule out/confirm the newer entities that can present as