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학습 자료 둘러보기 →A thunderclap headache is a red flag for subarachnoid hemorrhage (SAH). Blood in the subarachnoid space acts as a chemical irritant, causing meningismus.
Assess for nuchal rigidity by gently flexing the neck. A positive finding is stiffness and pain. Next, test for Kernig's sign: with the hip flexed to 90 degrees, attempt to extend the knee. Pain and resistance confirm meningeal irritation.
Do not rely on CT alone; a negative scan within the first 6 hours still requires a lumbar puncture to rule out xanthochromia. Avoid performing lumbar puncture if there are signs of increased intracranial pressure without prior imaging.
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