Neurosurgery & Cardiothoracic Surgery · NEET PG Preparation Surgery
A 65-year-old man with a history of long-standing hypertension presents with sudden onset of the 'worst headache of his life', followed by vomiting a…
Practice question from Neurosurgery & Cardiothoracic Surgery (NEET PG Preparation Surgery), with the correct answer and a step-by-step solution.
medium · MCQ · Q-B6668C
A 65-year-old man with a history of long-standing hypertension presents with sudden onset of the 'worst headache of his life', followed by vomiting and a brief loss of consciousness. On examination, he is stiff-necked and photophobic, but has no focal neurological deficits. Non-contrast CT head shows hyperdensity in the basal cisterns and sulci. What is the most common underlying cause of this condition?
- A.Arteriovenous malformation
- B.Saccular (berry) aneurysm ruptureCorrect answer
- C.Hypertensive intracerebral hemorrhage
- D.Mycotic aneurysm
Solution
The clinical presentation of a thunderclap headache ('worst headache of my life') with meningeal signs and blood in the basal cisterns on CT is classic for a subarachnoid hemorrhage (SAH). The most common cause of spontaneous SAH is the rupture of a saccular (berry) aneurysm, frequently located at the bifurcation of vessels in the circle of Willis.
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