A 30-year-old male presents with sudden-onset severe headache, vomiting, and altered mental status. On neurological examination, he has nuchal rigidity, and Kernig and Brudzinski signs are positive. What is the most appropriate initial management for this patient? A) Administer analgesics for headache relief B) Start empiric antibiotic therapy C) Order a brain CT scan without contrast D) Perform a lumbar puncture Answer: C) Order a brain CT scan without contrast Explanation: The patient's clinical presentation of sudden-onset severe headache, vomiting, altered mental status, nuchal rigidity, and positive Kernig and Brudzinski signs raises concern for possible subarachnoid haemorrhage or meningitis. The most appropriate initial step in management is to order a brain CT scan without contrast to rule out any acute intracranial pathology that may require urgent intervention before proceeding to a lumbar puncture.
