A 48-year-old woman presents with sudden onset "worst-ever" occipital headache while exercising, associated with vomiting and brief loss of consciousn...

Question

A 48-year-old woman presents with sudden onset "worst-ever" occipital headache while exercising, associated with vomiting and brief loss of consciousness. She presents 6 hours later. CT brain without contrast is normal. Neurological examination is normal but she remains photophobic. What is the most appropriate next diagnostic step?

Accepted Answer

Lumbar puncture to assess for xanthochromia

Answer

No further testing; treat as migraine

Answer

CT brain with contrast only

Answer

Start prophylactic nimodipine without further tests

Answer

Carotid Doppler ultrasound

au-amc MCQ (SBA): Subarachnoid haemorrhage