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Subarachnoid haemorrhage — DipIMC MCQ

Instant feedback + full explanation. One question, done properly.

ModerateMedical EmergenciesSubarachnoid haemorrhageDipIMC

A 73-year-old woman has sudden severe headache, vomiting and collapse while shopping. She opens eyes to pain, is confused and has neck stiffness; glucose is normal. What is the most appropriate transport decision?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Transport urgently to an emergency department with pre-alert for possible subarachnoid haemorrhage

Thunderclap headache with vomiting, reduced consciousness and meningism is concerning for subarachnoid haemorrhage and requires urgent hospital assessment. Aspirin before imaging may worsen bleeding. Symptom improvement does not make SAH safe to manage at home. The pearl is that the worst headache plus collapse should not be treated as uncomplicated migraine.

Reference: JRCALC Guidelines 2025; NICE Headaches CG150