Question

A 56-year-old woman presents with acute onset severe headache described as 'worst ever' and vomiting. She has neck stiffness and photophobia. CT brain performed within 1 hour of onset is normal. What is the most appropriate next investigation?

Accepted Answer

Lumbar puncture to assess for xanthochromia and red blood cells

Answer

No further investigation; treat as migraine

Answer

MRI brain in 6 months

Answer

CT angiography only if symptoms recur

Answer

Carotid Doppler ultrasound

Practice question

A 56-year-old woman presents with acute onset severe headache described as 'worst ever' and vomiting. She has neck stiffness and photophobia. CT brain performed within 1 hour of onset is normal. What is the most appropriate next investigation?