Headache 353337.A 75-year-old man presents to the ED with a depressed level of con-
sciousness. His wife is at the bedside and states he was stacking heavy boxes
when he complained of a sudden intense headache. He subsequently sat
down on the couch and progressively lost consciousness. She states that he
had a headache the previous week that was also sudden but not as intense.
He had gone to visit his primary-care physician who sent him to have a CT
scan of the brain, which was normal. Over the course of the past week, he
complained of intermittent pulsating headaches for which he took suma-
triptan. In the ED, you intubate the patient and obtain the noncontrast head
CT seen below. The scan is most consistent with which diagnosis?
(Courtesy of Adam J Rosh, MD.)a. Meningoencephalitis
b. SHA
c. Normal pressure hydrocephalus
d. Epidural hematoma
e. Subdural hematoma