skip to main content

Subarachnoid haemorrhage — MCCQE Part 1 MCQ

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

HardHeadacheSubarachnoid haemorrhageMCCQE Part 1

A 49-year-old woman presents 3 hours after sudden onset of the worst headache of her life while exercising. She vomited twice and has photophobia, but neurological examination is normal. Blood pressure is 162/94 mmHg. What is the most appropriate investigation?

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

Reveal the answer and explanation

Correct answer: D — Non-contrast CT head immediately

A thunderclap headache requires urgent exclusion of subarachnoid haemorrhage, and non-contrast CT head is the first investigation when presentation is within hours. Lumbar puncture may follow if CT is negative and suspicion remains, but it is not the initial test. A normal neurological examination does not exclude SAH.

Reference: Canadian Stroke Best Practices; MCC Objectives—Headache