Sudden Headache and Vomiting in a 33-Year-Old Woman

Roshen Mathew, MBBS; Mathew Abraham, MD, DM


September 12, 2016

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A 33-year-old woman presents to the emergency department with a severe headache that started suddenly 6 hours earlier. She states that it is the worst headache of her life, that she does not usually get headaches, and that the pain has been worsening despite her use of oral analgesic medication (namely, acetaminophen). She has had associated vomiting, both at home and since arrival at the emergency department.

Her headache is associated with mild blurred vision and weakness in her left leg that started about an hour ago. She denies having any fever, loose stools, seizures, or other visual symptoms (such as floaters, fortification, or loss in visual acuity).

Her medical history is unremarkable, with no hospitalizations other than for an uncomplicated delivery 8 years ago. Her only medication, other than the recent use of acetaminophen, is an oral contraceptive pill that she has taken for the past 4 years. She denies using any tobacco, alcohol, or recreational drugs.


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