4th November 2020

A 25-year-old woman presents to A&E with “the worst headache of my life” (2)

A 25-year-old woman presents to A&E with “the worst headache of my life”. She describes feeling like she was hit over the back of the head, whilst helping her friend to move a sofa out of her house. The pain was so severe that she had to lie down and has vomited several times since it started about 8 hours ago. No painkillers have helped. Her vision has been intermittently blurred since. She has been feeling hot and sweaty. Her past medical history is notable for primary biliary cirrhosis, for which she is currently under active surveillance, and she takes no regular medication – aside from the combined oral contraceptive pill. 

Which THREE of the following features are “red flags” for subarachnoid haematoma? Select THREE options only.