Question

A 62-year-old man with long-standing hypertension and hyperlipidemia presents with sudden severe occipital headache and normal neuro exam. Noncontrast head CT at 3 hours is negative. Next best step to rule out SAH?

Accepted Answer

Lumbar puncture to assess for xanthochromia

Answer

No further testing; CT rules out SAH at 3 hours

Answer

MRI brain only

Answer

CT angiography alone is sufficient

Answer

Start anticoagulation

Practice question

A 62-year-old man with long-standing hypertension and hyperlipidemia presents with sudden severe occipital headache and normal neuro exam. Noncontrast head CT at 3 hours is negative. Next best step to rule out SAH?