Question:
A patient presents with sudden onset of severe headache with neck rigidity. The most likely diagnosis is:
A patient presents with sudden onset of severe headache with neck rigidity. The most likely diagnosis is:
Show Hint
Sudden thunderclap headache plus meningism points to bleeding around the brain, not infection.
Updated On: Jun 23, 2026
- Intraparenchymal hemorrhage
- Subarachnoid hemorrhage
- Meningitis
- None of the above
Show Solution
Verified By Collegedunia
The Correct Option is B
Solution and Explanation
Answer: Subarachnoid hemorrhage (SAH).
Step 1: The combination of SUDDEN onset, very severe headache (the classic thunderclap or worst headache of my life) plus neck rigidity is the textbook presentation of SAH, usually from a ruptured berry aneurysm.
Step 2: Blood in the subarachnoid space irritates the meninges, producing meningismus (neck stiffness, photophobia), nausea, vomiting and sometimes brief loss of consciousness or seizures.
Step 3: Why not the others. Intraparenchymal hemorrhage usually gives focal neurological deficits that build up, not isolated thunderclap headache with meningism. Meningitis causes neck rigidity too, but it evolves over hours to days with fever, not as an instant sudden-onset event. The pattern of abrupt headache plus stiff neck is most specific for SAH.
Hence SAH is correct.
Ref: Harrison's Principles of Internal Medicine, 20e.
Step 1: The combination of SUDDEN onset, very severe headache (the classic thunderclap or worst headache of my life) plus neck rigidity is the textbook presentation of SAH, usually from a ruptured berry aneurysm.
Step 2: Blood in the subarachnoid space irritates the meninges, producing meningismus (neck stiffness, photophobia), nausea, vomiting and sometimes brief loss of consciousness or seizures.
Step 3: Why not the others. Intraparenchymal hemorrhage usually gives focal neurological deficits that build up, not isolated thunderclap headache with meningism. Meningitis causes neck rigidity too, but it evolves over hours to days with fever, not as an instant sudden-onset event. The pattern of abrupt headache plus stiff neck is most specific for SAH.
Hence SAH is correct.
Ref: Harrison's Principles of Internal Medicine, 20e.
Was this answer helpful?
0
0
Top NEET PG Medicine Questions
- Identify the condition associated with the murmur in the image below
- A young man came to the medical OPD with complaints of early morning backache and stiffness, which improves on exercise, and persistent red eyes. On examination, lung expansion was less than 3 cm. X-ray is shown in the image given below.
What is the most probable diagnosis? - A patient with hyperkalemia and elevated urea levels underwent dialysis. Towards the end of the session, she became drowsy and had a sudden seizure episode. On examination, thepatient was hypotensive. What is the treatment for this condition?
- A female patient presents to the emergency department with severe restlessness, palpitations, and tremors. She is a known case of bronchial asthma. On examination, the neck looksswollen. Blood pressure is elevated, and tachycardia is noted. ECG shows atrial fibrillation.Which of the following drugs is used for immediate management in this patient?
- A 30-year-old male is found to be positive for HBsAg and HBeAg and is diagnosed with chronic hepatitis B. The patient’s viral load was 2x 100000 and SGPT is found to be doubled. What is the appropriate management in this patient? SGPT-Serum glutamate pyruvate transaminase
View More Questions
Top NEET PG Subarachnoid hemorrhage Questions
Top NEET PG Questions
- A patient hailing from Delhi presents with fever, arthralgia, and extensive petechial rash for 3 days. Lab investigations revealed a hemoglobin of 9 g/ dL, a white blood cell count of 9000 cells/mm3, a platelet count of 20000 cells/mm3, and a prolonged bleeding time. The clotting time was normal. What is the most likely diagnosis?
- Which of the following statements is true about Trichomonas vaginalis?
- A lady from West Rajasthan presented with an ulcer surrounded by erythema on the right leg. Microscopy of the biopsy from the edge of the ulcer showed organisms with dark staining nuclei and kinetoplast. What is the most likely causative agent?
- A child presents with a fever and a rash. Urine examination showed cells with owl's eye appearance. What is the most likely diagnosis?
- Infection with Clonorchis sinensis is associated with an increased risk of__?
View More Questions