Question

A 50-year-old man presents with sudden onset severe headache, described as 'thunderclap'. He has neck stiffness and photophobia. A non-contrast CT head performed 4 hours after onset is reported as normal. What is the most appropriate next step to exclude subarachnoid haemorrhage (SAH)?

Accepted Answer

Lumbar puncture for xanthochromia

Answer

Repeat CT head in 24 hours

Answer

MRI brain

Answer

CT angiogram of cerebral vessels

Answer

Observation and symptomatic relief

Practice question

A 50-year-old man presents with sudden onset severe headache, described as 'thunderclap'. He has neck stiffness and photophobia. A non-contrast CT head performed 4 hours after onset is reported as normal. What is the most appropriate next step to exclude subarachnoid haemorrhage (SAH)?