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Subarachnoid haemorrhage — RCPSC EM MCQ

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ModerateNeurological emergenciesSubarachnoid haemorrhageRCPSC EM

CTAS 2. A 45-year-old has a thunderclap headache that peaked instantly 9 hours ago. Neuro exam is normal and non-contrast CT head is reported normal. She vomited twice and has neck stiffness. What is the most appropriate investigation?

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Correct answer: A — CT angiography or lumbar puncture to assess SAH

After a negative CT beyond the early high-sensitivity window, further testing with LP or CTA is needed when suspicion for SAH remains.

Reference: Canadian Association of Emergency Physicians SAH literature; Ottawa SAH Rule studies