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Emerg Med J 2007;24:e23 doi:10.1136/emj.2006.041954
  • Emergency casebook

Acute neck pain, an atypical presentation of subarachnoid haemorrhage

  1. Julian Ahmed,
  2. Chris Blakeley,
  3. Ramy Sakar,
  4. Khalida Aktar,
  5. Kambiz Hashemi
  1. Mayday Hospital, Croydon, UK
  1. Correspondence to:
 MrC Blakeley
 Mayday Hospital, London Road, Croydon CR7 7YE, UK; christopher.blakeley{at}mayday.nhs.uk
  • Accepted 14 November 2006

Abstract

Subarachnoid haemorrhage can be a massively debilitating condition with long-term repercussions. The “classic” presentation of sudden-onset severe headache normally raises suspicions. However, if the presentation is atypical, the diagnosis may be missed. We report on a 52-year-old man who presented with a 1-day history of progressively worsening right-sided neck pain spreading to the chest with associated symptoms of autonomic dysfunction. After initial stabilisation, the patient’s Glasgow Coma Scale (GCS) score declined, with subsequent CT scan showing an extensive subarachnoid haemorrhage.

Footnotes

  • Competing interests: None declared.

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