I felt like a bomb had burst in my head," said Sara as she lay on a stretcher in the emergency room, keeping her eyes closed and requesting us to dim the lights. She didn't feel like talking. Her parents said she had been sitting on the couch after dinner, reading a book when it had happened. No high blood pressure, no diabetes, and no family history of stroke, they confirmed. She didn't drink or smoke. No real or even apparent stress. She was 35 years old and about to be married. May be that was stress enough, I postulated in jest to myself.

She had a throbbing headache and felt confused, but was conscious and able to follow simple commands briskly. She could raise both her arms and flap her feet up and down at the ankle, which confirmed she had no striking neurological deficit. Her neck was stiff, however, and she couldn't touch her chin to the chest, one of the signs of an aneurysm rupture in the brain (you don't need to try doing this at home; you are fine).