A 40-year-old man presents to the ED with sudden onset severe headache, described as 'thunderclap'. He has vomited once and has mild neck stiffness. N...

Question

A 40-year-old man presents to the ED with sudden onset severe headache, described as 'thunderclap'. He has vomited once and has mild neck stiffness. Neurological examination is normal. CT head scan is reported as normal. What is the most appropriate next investigation according to NICE guidelines?

Accepted Answer

Lumbar puncture for xanthochromia

Answer

MRI brain

Answer

MR Angiogram

Answer

Repeat CT head in 24 hours

Answer

Transcranial Doppler ultrasound

ukmla MCQ (SBA): Thunderclap Headache / Subarachnoid Haemorrhage Rule-out

A 40-year-old man presents to the ED with sudden onset severe headache, described as 'thunderclap'. He has vomited once and has mild neck stiffness. Neurological examination is normal. CT head scan is reported as normal. What is the most appropriate next investigation according to NICE guidelines?