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Nervous System & Special Senses

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This patient was woken up by an acute severe headache : a typical \u0022thunderclap\u0022 headache. This should be assumed to be due to a subarachnoid hemorrhage (SAH) until proven otherwise.\n\nThe other life threatening conditions which may present with an acute headache include intracerebal hemorrhage, cervical arterial dissection, acute hypertensive crises, pituitary apoplexy and intracranial infections. Unfortunately, it is impossible to reliably differentiate between these etiologies on clinical grounds alone.\n\nA CT scan of the brain is a good first line diagnostic test, but turns out to be negative in this patient. As a lumbar puncture may yield useful information, this should be performed next.\n\nThe CSF analysis shows the presence of a large nu"}]}

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