Question

A 36-year-old with severe headache and neck stiffness arrives within 2 hours of onset with focal deficits. Noncontrast CT normal; suspicion for subarachnoid haemorrhage persists. Next best step?

Accepted Answer

Lumbar puncture or CT angiography to evaluate for SAH

Answer

Discharge with migraine therapy

Answer

Start heparin for possible cerebral venous thrombosis

Answer

MRI brain in 1 week

Answer

No further testing needed because CT is negative

Practice question

A 36-year-old with severe headache and neck stiffness arrives within 2 hours of onset with focal deficits. Noncontrast CT normal; suspicion for subarachnoid haemorrhage persists. Next best step?