Headache attributed to nontraumatic subarachnoid hemorrhage (SAH)

Abstract

A 55-year-old housewife who was the mother of one of my MS patients calls me on the phone sometime ago. I first thought she was calling for her daughter, but she said that she was calling this time for herself because she had a very severe headache. When asked to give information on the onset and other details of this headache, she described it as a sudden-onset very severe headache reaching its maximum intensity within minutes about three days ago. She had initially nausea and had vomited a few times and was admitted to a nearby hospital. At that hospital, her physical and neurological exams were noted as being normal, but the examining physician decided to refer her for a cranial CT scan, and in the meantime, she was given symptomatic analgesic therapy. However, she could receive a radiology appointment only for the following week! Then as her headache did not get any better, she decided to call me three days after the onset of her continuing severe headache. She replies of still having occasional nausea and some mild photophobia when asked, and despite feeling uncomfortable when standing still, she avoids moving around as her pain gets much worse then.