Question 223 · LEK · Cerebrovascular diseases
A 45-year-old woman, healthy so far, was admitted to the ER because of severe headache radiating to the neck. The pain began after lifting a heavy object. According to witnesses she became unconscious for a few minutes after the headache started (no convulsions, no urination). On physical examination: GCS (Glasgow Coma Scale) 15 points, arterial blood pressure 140/85 mmHg, Kernig’s sign present, nuchal rigidity 3 fingers. Which of the following is the first testing of choice that enables the diagnosis?
- A. electroencephalography (EEG).
- B. computed tomography scan of the head, without contrast.
- C. MRI of the cervical spine.
- D. examination of the cerebrospinal fluid.
- E. continuous, at least 24-hour video-EEG monitoring.
Hint
Thunderclap headache after exertion, brief loss of consciousness and meningeal signs call for a fast, widely available scan that detects blood.
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