A 52-year-old has a thunderclap headache that began 90 minutes ago. Neurological examination is normal. Non-contrast CT head is performed within six h...

Question

A 52-year-old has a thunderclap headache that began 90 minutes ago. Neurological examination is normal. Non-contrast CT head is performed within six hours, reported by a radiologist and shows no subarachnoid haemorrhage. What is the most appropriate next step?

Accepted Answer

Assess alternative causes without routine lumbar puncture

Answer

Perform lumbar puncture after the early negative CT

Answer

Discharge with an alternative headache diagnosis and safety-netting

Answer

Start nimodipine before any diagnosis is established

Answer

Repeat CT daily for three days before deciding

Neurology — MRCEM SBA MCQ

A 52-year-old has a thunderclap headache that began 90 minutes ago. Neurological examination is normal. Non-contrast CT head is performed within six hours, reported by a radiologist and shows no subarachnoid haemorrhage. What is the most appropriate next step?