Imaging in a 35-year-old woman with progressive headache.

© 2014 Canadian Medical Association or its licensors CMAJ 1 A 35-year-old woman presents with a onemonth history of progressive global headaches, which last from hours to a day. The headaches are associated with visual blurring and paresthesia involving the left side of her face. She sometimes experiences nausea and vomiting with the headaches. On a few occasions, her headaches have been associated with sexual intercourse. Her headaches are now affecting her ability to work. She has a history of occasional headaches. A distant relative on the maternal side of her family died from subarachnoid hemorrhage associated with a cerebral aneurysm. On examination, the patient is slightly overweight and there is possibly some blurring of the optic disc margins bilaterally. Neurological examination is otherwise unremarkable.