What is the hallmark symptom of subarachnoid hemorrhage?

• A. Severe headache that comes suddenly
• B. Gradual, mild headache
• C. Back pain
• D. Numbness in extremities

Answer: (A)

Subarachnoid hemorrhage presents most notably with a sudden, severe headache that reaches its maximum intensity within seconds to a minute—often described as the worst headache of life. This thunderclap onset reflects abrupt bleeding into the subarachnoid space from a ruptured vessel, typically an aneurysm, and is the hallmark that sets SAH apart from other headaches. The other options don’t fit this picture: a gradual, mild headache suggests tension or migraine; back pain points to spinal or musculoskeletal issues; numbness in the extremities implies a focal stroke or neuropathy rather than SAH. If this symptom occurs, it’s an emergency requiring immediate medical evaluation and imaging.