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Subarachnoid hemorrhage — ABEM Board MCQ

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HardNeurological emergenciesSubarachnoid hemorrhageABEM Board

A 41-year-old woman arrives as ESI 2 with sudden severe headache that peaked within seconds. BP 156/88, HR 92, neurologic examination is normal. Noncontrast head CT performed 14 hours after onset is negative. Which of the following is the most appropriate imaging study?

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

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Correct answer: B — CT angiography of the head

When SAH remains a concern after a negative CT beyond the early window, CTA is one accepted next diagnostic pathway when imaging is selected; LP is the non-imaging alternative.

Reference: ACEP Clinical Policy: Headache; AHA/ASA aneurysmal SAH guidance