Question
A 42-year-old labourer developed a sudden, severe and persistent headache, accompanied by vomiting and neck pain. He was evaluated at the nearest hospital where an emergency computed tomography was negative for stroke. Which one of the following investigations is best to confirm the diagnosis?
This question was previously asked in
UPSC CMS 2026 Surgery, Gynaecology & Obstetrics, and PSM Question Paper (02-Aug-2026)
The correct answer is
Lumbar puncture after 12 hours
This presentation is classic for subarachnoid haemorrhage (thunderclap headache, vomiting, neck stiffness). When CT is negative, lumbar puncture performed after at least 12 hours from symptom onset is the confirmatory test, looking for xanthochromia from breakdown of red blood cells in the CSF.
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