A 45-year-old woman with long-standing poorly controlled hypertension presents with a severe occipital headache described as "the worst of her life" a...

Question

A 45-year-old woman with long-standing poorly controlled hypertension presents with a severe occipital headache described as "the worst of her life" and associated with neck stiffness and photophobia. Blood pressure is 190/110 mmHg. Non-contrast CT brain is normal. What is the most appropriate next investigation?

Accepted Answer

Lumbar puncture to assess for xanthochromia and subarachnoid haemorrhage

Answer

MRI brain with contrast

Answer

Repeat CT brain in 24 hours

Answer

Carotid Doppler ultrasound

Answer

No further investigation as CT is normal

au-amc MCQ (SBA): Suspected subarachnoid haemorrhage