Which condition is the most likely cause of a negative lumbar puncture in a patient presenting with a headache?

A negative lumbar puncture, which means that the cerebrospinal fluid (CSF) analysis yields no significant findings, is most commonly associated with migraine headaches. In the context of a patient presenting with a headache, migraines are considered a primary headache disorder, and a negative lumbar puncture is expected because there is no underlying pathology that would alter the CSF composition, such as infection or bleeding.

Migraines typically do not present with any abnormal findings in the CSF. In contrast, conditions like meningitis or subarachnoid hemorrhage would likely yield positive findings in the lumbar puncture, such as increased white blood cells, elevated protein, or red blood cells, respectively. Subdural hematomas could also complicate CSF evaluation, but like migraines, they do not typically show specific changes when a lumbar puncture is performed unless there are secondary complications.

Therefore, recognizing that migraine headaches result in a negative lumbar puncture helps differentiate them from other more serious conditions that would be identified through CSF analysis.