A 35-year-old woman presents with severe sudden-onset occipital headache described as the worst of her life, associated with vomiting and photophobia....

Question

A 35-year-old woman presents with severe sudden-onset occipital headache described as the worst of her life, associated with vomiting and photophobia. Her neurological examination is normal and CT brain performed within one hour of onset is reported as normal. What is the most appropriate next step?

Accepted Answer

Perform lumbar puncture to assess for xanthochromia

Answer

Reassure and discharge with simple analgesia

Answer

Arrange outpatient MRI brain in 2 weeks

Answer

Start migraine prophylaxis immediately

Answer

Begin high-dose corticosteroids for presumed vasculitis

au-amc MCQ (SBA): Subarachnoid haemorrhage investigation