Sudden-Onset, Severe Occipital Headache | Headache (Assessment & Diagnosis) — 52yo Woman | Neurology | MCCQE1 Q#4791
MCCQE1 Question #4791
Dimension of Care
Acute Care
Activity
Assessment & Diagnosis
Objective
Headache
Section
Medicine / Family Medicine
Subject
Neurology
Last updated: February 2026
A 52-year-old woman presents to the emergency department with sudden-onset, severe occipital headache that began 1 hour ago while lifting a heavy box. She calls it the worst headache of her life and has nausea and brief neck stiffness. She has no fever, photophobia, or history of head trauma. Neurologic examination shows no focal deficits. Noncontrast CT head shows hyperdensity in the basal cisterns compatible with subarachnoid hemorrhage from a saccular aneurysm at a circle of Willis branch point. A chronic defect in which arterial wall component most strongly predisposes to formation of these aneurysms?
Full answer analysis and choices are available inside the practice session.
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