A 29-year-old man presents with sudden severe 'thunderclap' headache, described as the worst of his life, reaching maximal intensity within seconds. C...

Question

A 29-year-old man presents with sudden severe 'thunderclap' headache, described as the worst of his life, reaching maximal intensity within seconds. CT head without contrast performed within 2 hours of onset is normal. He remains symptomatic. What is the most appropriate next investigation to exclude subarachnoid haemorrhage?

Accepted Answer

Lumbar puncture to look for xanthochromia

Answer

Repeat CT head in 6 months

Answer

Carotid Doppler ultrasound

Answer

Plain skull X-ray

Answer

No further investigation is needed as CT is normal

uk-plab-1 MCQ (SBA): Subarachnoid haemorrhage – investigation