Quiz: What’s causing this patient’s headaches?

This is a tricky one!

A 50-year-old female presents to the emergency department with a two-week history of headaches.

headache woman

The pain is widespread and throbbing in nature, lasts between several hours and several days, and is refractory to over-the-counter analgesics.

She also reports a constant whooshing noise in her ears, which has become louder and more debilitating in the past few days.

Physical examination is unremarkable and a later angiography reveals the findings seen here.

In this patient’s likely diagnosis, which of the following other