A 64-year-old man develops sudden onset severe occipital headache described as "the worst headache of my life" while lifting a box. He vomits and beco...

Question

A 64-year-old man develops sudden onset severe occipital headache described as "the worst headache of my life" while lifting a box. He vomits and becomes photophobic but has no focal neurological deficit. What is the most appropriate initial investigation?

Accepted Answer

Non-contrast CT head as soon as possible.

Answer

MRI brain with contrast.

Answer

Lumbar puncture immediately in the emergency department without imaging.

Answer

Carotid Doppler ultrasound.

Answer

CT cerebral angiography only.

uk-plab-1 MCQ (SBA): Suspected subarachnoid haemorrhage

A 64-year-old man develops sudden onset severe occipital headache described as "the worst headache of my life" while lifting a box. He vomits and becomes photophobic but has no focal neurological deficit. What is the most appropriate initial investigation?