A 37-year-old man suddenly developed an acute headache accompanied by nausea. vomiting, and impaired consciousness. Objectively blood pressure is 190/120 mm Hg. The face is hyperemic. Patient’s consciousness is clouded, his answers to the questions are short, monosyllabic. Movement and sensory disturbances are absent. Meningeal signs are positive. Cerebrospinal fluid contains blood. What provisional diagnosis can be made?

Answer options

1. Meningitis
2. Encephalitis
3. Ischemic stroke
4. Subarachnoid hemorrhage
5. Cerebral vascular embolism

Explanation

A 37-year-old man suddenly developed an acute headache accompanied by nausea. vomiting, and impaired consciousness. Objectively blood pressure is 190/120 mm Hg. The face is hyperemic. Patient’s consciousness is clouded, his answers to the questions are short, monosyllabic. Movement and sensory disturbances are absent. Meningeal signs are positive. Cerebrospinal fluid contains blood. What provisional diagnosis can be made?