13th August 2024

A 67-year-old man presents to your neurology clinic with a 2 year history of worsening headache

A 67-year-old man presents to your neurology clinic with a 2 year history of worsening headache. He tells you that when he coughs or sneezes he develops a bilateral headache that lasts for up to a minute. It is not associated with any other symptoms and he denies visual changes, limb weakness of sensory changes. He has a past medical history of COPD, depression and peripheral vascular disease. On fundoscopy, his optic discs are normal. He has normal power, sensation and coordination in all limbs. An MRI brain with contrast is performed which is normal.

What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.