Picture Quiz: A young patient with a severe headache

Abstract

A 38 year old woman presented with one day history of acute onset frontal headache which progressively generalised over a few hours. The headache was dull in nature and did not respond to analgesics. A day prior to the onset of headache her family members and the patient had noticed a distinct change in the appearance of her eyes. The headache was not associated with symptoms of meningism, vomiting, seizures, syncope or loss of consciousness. She did not report any weakness in her extremities. There was no recent history of neck trauma or neck pain and no other systemic symptoms.