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A patient presenting with a sudden onset of severe headache and neck stiffness is highly suggestive of meningitis. This condition, which can be either viral or bacterial in origin, typically manifests with symptoms including a severe headache, neck stiffness (due to meningeal irritation), fever, and altered mental status in some cases.

The sudden nature of the symptoms is particularly notable; in the case of meningitis, headaches can escalate quickly and may be accompanied by a stiff neck due to irritation of the meninges. A classic clinical sign associated with meningitis is photophobia, alongside other systemic signs like fever, which further supports the diagnosis.

While other conditions like a brain tumor, stroke, or cervical spondylosis can cause headaches, they are less characterized by the combination of sudden, severe headache and neck stiffness. For instance, brain tumors typically present with gradual symptoms worsening over time, and strokes often involve focal neurological deficits rather than the widespread meningeal irritation seen in meningitis. Cervical spondylosis is primarily a degenerative condition affecting the cervical spine and generally does not cause acute neck stiffness associated with systemic symptoms. Therefore, the clinical presentation aligns perfectly with meningitis as the most likely condition in this scenario.