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A patient presents with sudden-onset severe headache, vomiting, and altered mental status. Imaging reveals a noncontrast-enhancing hemorrhagic lesion within the subarachnoid space. Which of the following neurological conditions is most likely responsible for these symptoms?

  • A. Ischemic stroke
  • B. Subdural hematoma
  • C. Intracerebral hemorrhage
  • D. Subarachnoid hemorrhage
Correct Answer: D

Rationale: The correct answer is D: Subarachnoid hemorrhage. This condition presents with sudden-onset severe headache, vomiting, and altered mental status due to bleeding in the subarachnoid space. This type of hemorrhage is typically noncontrast-enhancing on imaging.

A: Ischemic stroke does not typically present with sudden-onset severe headache and vomiting.
B: Subdural hematoma usually presents with a slower onset of symptoms and often develops after head trauma.
C: Intracerebral hemorrhage presents with focal neurological deficits rather than altered mental status and vomiting.

In summary, based on the sudden onset of symptoms, imaging findings, and clinical presentation, subarachnoid hemorrhage is the most likely diagnosis in this case.