When a patient presents to an emergency department with the new onset of headache, lethargy or altered mental status without the development of a “focal” neurological deficit, it is imperative that intracranial hemorrhage be high in the differential diagnosis list. One can suffer a subarachnoid hemorrhage or an intracerebral hemorrhage without focal neurological deficit but with severe headache and altered mental status. What should be done to evaluate such a patient? A CT scan of the head. When should it be performed? quickly. Why? Because the causes of subarachnoid hemorrhages are treatable if diagnosed and treated before the lesion rebleeds. The same is applicable to arteriovenous malformations (AVMs)within the brain.