A 50-year-old woman with a history of migraines presents with the worst headache of her life, which reached peak intensity within seconds. What is the likely diagnosis and next steps?
This patient's symptoms suggest a possible subarachnoid hemorrhage (SAH), a life-threatening condition that can present with a sudden, severe headache often described as "the worst headache of my life." Even though she has a history of migraines, this new, more severe headache is concerning and should be evaluated immediately. A CT scan of the head should be done urgently. If the CT scan does not show hemorrhage and suspicion is still high, a lumbar puncture should be performed.