A 52-year-old woman presented to the emergency department with sudden-onset severe headache, described as the "worst headache of her life." The headache occurred while she was at home, watching television, and was immediately associated with nausea and vomiting. She also experienced brief episodes of confusion and blurred vision.

Upon arrival at the hospital, the patient was visibly distressed and unable to sit still due to the intensity of her headache. Her vital signs indicated hypertension, with a blood pressure of 180/100 mmHg, and she was tachycardic. A neurological examination revealed slight photophobia and mild neck stiffness, but she was fully conscious and oriented.

Given her presentation, a non-contrast computed tomography (CT) scan of the head was performed. The scan showed hyper density in the subarachnoid space, indicating the presence of blood, consistent with subarachnoid haemorrhage (SAH). The patient was immediately admitted to the neurocritical care unit for further management.

The neurosurgical team was consulted, and a cerebral angiogram was performed to identify the source of the haemorrhage. The angiogram revealed a ruptured anterior communicating artery aneurysm. The patient underwent surgical clipping of the aneurysm to prevent rebleeding.

During her hospital stay, she was closely monitored for neurological changes and complications. She was started on calcium channel blockers to prevent vasospasm, which can occur after SAH. After a few days of stabilization and improvement in her symptoms, the patient was discharged with instructions for follow-up care and a rehabilitation plan.