Q:

A 29 year old woman who was diagnosed to have migraine presents with severe onset of occipital headache. She lost her consciousness. CT=normal. Neurological exam=normal. What is the most appropriate management?

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A 29 year old woman who was diagnosed to have migraine presents with severe onset of

occipital headache. She lost her consciousness. CT=normal. Neurological exam=normal. What is

the most appropriate management?


  1. Repeat CT
  2. MRI
  3. LP
  4. XR
  5. No investigation required

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The key is E. No investigation required. This is wrong key. Correct key should be C. LP. [To label

basilar migraine we need at least history of three attacks which is not present here and for this we have

to exclude subarachnoid hemorrhage doing LP fter 12 hours of symptom by which time xathochromia of

CSF develops].

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