Medicine

at a Glance

Fourth EditionEdited by Patrick Davey

Multiple Choice: Neurology

Question 1. A 35-year-old woman with frequent migraine presents on the acute take with a headache, the worst ever, starting suddenly and associated with vomiting and possible photophobia. Examination is unremarkable, except for questionable neck stiffness and possible photophobia. Which of the following statements is true?

A A head scan should be performed, and if unremarkable an lumbar puncture performed
B The probability of a subarachnoid haemorrhage is low; she should be sent home and told to return if the headache worsens
C The probability of SAH is high, and she should be transferred to a neurosurgical centre prior to any imaging as time is of the essence
D She should be given non-steroidal anti-inflammatory agents, admitted and observed
E She should be given an antidepressant, along with cognitive-behavioural therapy
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