Question

A 52-year-old man with long-standing poorly controlled hypertension presents with sudden severe occipital headache, vomiting and neck stiffness. BP is 190/110 mmHg. CT head within 6 hours is normal. What is the next best investigation to confirm or exclude subarachnoid haemorrhage?

Accepted Answer

Lumbar puncture for xanthochromia

Answer

Repeat CT head in 24 hours

Answer

MRI brain with contrast

Answer

CT angiography of cerebral vessels

Answer

Carotid Doppler ultrasound

Practice question

A 52-year-old man with long-standing poorly controlled hypertension presents with sudden severe occipital headache, vomiting and neck stiffness. BP is 190/110 mmHg. CT head within 6 hours is normal. What is the next best investigation to confirm or exclude subarachnoid haemorrhage?