Routine investigation of serum calcium is not recommended in ASA one and two patients unless abnormalities of calcium metabolism are clinically suspected. The clinical features of hypocalcaemia can often be subtle and may manifest in the presence of associated factors. Hypoparathyroidism, an important cause of hypocalcaemia, often presents as soft tissue calcification (ostosis). Ligamentum flavum ostosis can present with compressive myelopathy requiring laminectomy. We report a case of ligamentum flavum ostosis and subclinical hypocalcaemia due to hypoparathyroidism, who went undetected pre-operatively resulting in significant post-operative morbidity.

Trigeminal Autonomic Cephalgia (TAC) refers to a group of disorders involving afferent activation of trigeminal system from the pain-perceiving intracranial structures. Short unilateral neuralgiform headache with conjunctival redness and tearing (SUNCT) is a sub-group of TAC which at times can be refractory to treatment. Percutaneous balloon compression (PBC) of the trigeminal ganglion is an established treatment modality for trigeminal neuralgia. However, PBC has been sparingly utilized for treatment of SUNCT. In this case report we intend to highlight good long-term results of PBC for treatment of refractory SUNCT.

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