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Subarachnoid haemorrhage — ACEM Fellowship MCQ

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

HardNeurological emergenciesSubarachnoid haemorrhageACEM Fellowship

A 43-year-old has a thunderclap headache during exercise. CT head performed ten hours after onset is normal, but meningism persists. Which next investigation is most appropriate?

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

Reveal the answer and explanation

Correct answer: A — Lumbar puncture after senior discussion

Explanation lettering: C = shown as A · A = shown as B · D = shown as C · E = shown as D · B = shown as E

C is correct. A negative CT performed more than six hours after a convincing thunderclap headache does not end the subarachnoid-haemorrhage pathway. Further investigation, including lumbar puncture after senior discussion, is considered.

Reference: NSW Agency for Clinical Innovation: Subarachnoid haemorrhage clinical tool: https://aci.health.nsw.gov.au/networks/eci/clinical/tools/neurology/headache/subarachnoid-heamorrhage