Florida State Paramedic Practice Exam

A 32-year-old woman presents with an excruciating headache during a workout and loses consciousness. What could be the cause?

1. Cerebral aneurysm

2. Subdural hematoma

3. Migraine

4. Hypoglycemia

The correct answer is: Cerebral aneurysm

The scenario described—a sudden, severe headache during exercise followed by loss of consciousness—is highly suggestive of a cerebral aneurysm. A cerebral aneurysm occurs when a blood vessel in the brain weakens and balloons, potentially leading to a rupture. The sudden onset of an "excruciating" headache, often described by patients as the "worst headache of my life," is a classic symptom of this condition. The loss of consciousness indicates significant neurological impact, which can occur if there is increased intracranial pressure or bleeding related to the aneurysm. In contrast, while a subdural hematoma could lead to similar symptoms, it typically follows head trauma, which isn't indicated in this scenario. A migraine, although it can cause severe headaches, usually does not result in loss of consciousness, and hypoglycemia may cause altered mental status but typically presents with other symptoms like sweating, shakiness, and confusion rather than a sudden excruciating headache during exertion. Therefore, the characteristics of the headache and the context of the incident align closely with a cerebral aneurysm being the most likely cause.