A 63-year-old woman on chronic Warfarin for atrial fibrillation presents with a sudden severe occipital headache described as "the worst of my life." ...

Question

A 63-year-old woman on chronic Warfarin for atrial fibrillation presents with a sudden severe occipital headache described as "the worst of my life." Blood pressure is 180/100 mm Hg, and she has neck stiffness but no focal neurological deficit. What is the most appropriate next diagnostic step?

Accepted Answer

Non-contrast CT head immediately

Answer

CT head with contrast

Answer

MRI brain only

Answer

Lumbar puncture without imaging

Answer

Reassure and prescribe analgesia for tension headache

ca-mccqe1 MCQ (SBA): Subarachnoid haemorrhage evaluation

A 63-year-old woman on chronic Warfarin for atrial fibrillation presents with a sudden severe occipital headache described as "the worst of my life." Blood pressure is 180/100 mm Hg, and she has neck stiffness but no focal neurological deficit. What is the most appropriate next diagnostic step?