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Case 20 

Case 20
Chapter:
Case 20
Author(s):

Harutomo Hasegawa

, Matthew Crocker

, and Pawan Singh Minhas

DOI:
10.1093/med/9780199599837.003.0020
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date: 18 August 2019

A 49-year-old woman presented to the emergency department with a one-week history of severe headache. The onset was sudden. It did not cause her to lose consciousness although she vomited once. Since then her headaches had continued, and they were so severe that she had been unable to leave the house for 3 days. She had been taking paracetamol and codeine analgesia to little effect. Her medical history was unremarkable but she had smoked 20 cigarettes daily since her teens. On examination she was alert and orientated and the neurological examination was unremarkable. She had no papilloedema. The physicians arranged a head CT scan following which she was referred to neurosurgery.

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