Question

A 47-year-old man presents with sudden onset severe occipital headache, described as the worst pain of his life, with photophobia and vomiting. Neurological examination is normal. CT head performed within 2 hours is reported as normal. What is the next most appropriate investigation?

Accepted Answer

Lumbar puncture for CSF analysis

Answer

Repeat CT head in 24 hours

Answer

MRI brain

Answer

CT angiography of cerebral vessels only

Answer

No further investigation, treat as migraine

Practice question

A 47-year-old man presents with sudden onset severe occipital headache, described as the worst pain of his life, with photophobia and vomiting. Neurological examination is normal. CT head performed within 2 hours is reported as normal. What is the next most appropriate investigation?