Question

A 65-year-old man presents with sudden-onset severe headache described as the worst of his life. Blood pressure is 190/100 mm Hg. On examination he is drowsy but arousable; neck is stiff. What is the most appropriate initial imaging investigation?

Accepted Answer

Non-contrast CT scan of the head immediately

Answer

MRI brain with gadolinium

Answer

Lumbar puncture as first-line without imaging

Answer

CT angiography only

Answer

No imaging is required; treat as migraine

Practice question

A 65-year-old man presents with sudden-onset severe headache described as the worst of his life. Blood pressure is 190/100 mm Hg. On examination he is drowsy but arousable; neck is stiff. What is the most appropriate initial imaging investigation?