A 64 year old man presents with sudden severe left sided headache and immediately vomited twice. He felt dizzy but there was no aura or visual disturbances. He has a previous history of migraine for which he takes Migraleve. The current headache is much more severe and he has never vomited with his usual attacks of migraine. He has a 2 year history of hypertension for which he is prescribed Ramipril by his GP.
Pyrexial 37.8, pulse 80 reg, BP 170/100 mmHg
Irritable and felt dizzy on movement of head
Fundi normal, no neck stiffness, no focal neurological signs
Symmetrical reflexes, plantars down going
Rest of physical examination was normal
What are the possible diagnosis?
What is your management?
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