Image of the Week: What is causing this patient's headaches?

A 50-year-old woman presents to the emergency department with a 2-week history of headaches. The pain is widespread and throbbing in nature, lasts between several hours and several days, and is refractory to OTC analgesics. She also reports a constant whooshing noise in her ears that has become louder and more debilitating in the past few days. Physical examination is ...