Crowned dens syndrome (CDS), a pseudogout attack involved with atlantoaxial 
joint, mimics meningitis, because jolt accentuation of headache, a physical sign 
for meningitis, is frequently considered mistakenly as 'positive' in CDS 
patients. Our patient with CDS experienced multiple ambulance transports and 
underwent lumbar puncture for suspected meningitis because of positive result of 
jolt accentuation of headache. We found that the patient actually had jolt 
accentuation of neck pain from CDS and treated her successfully. The 
characteristic physical finding produced by axial neck rotation in CDS patients 
is not headache, but a jolt accentuation of neck pain.