Which investigation is first for a patient with suspected subarachnoid haemorrhage with a thunderclap headache?
Answer and explanation
Correct answer: C. Non-contrast CT head
- Step 1: CT is most sensitive in the first six hours.
- Step 2: If CT is negative, lumbar puncture for xanthochromia follows.
Answer
Non-contrast CT head.
Why not the others: 'Lumbar puncture first' is done after CT if the scan is negative; 'Plain skull X-ray' does not show blood; 'EEG' is not used for diagnosis.
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