Which of the following symptoms would be least expected with vertigo?

Severe headache is the least expected symptom associated with vertigo because vertigo primarily involves a false sensation of spinning or movement, often due to issues in the inner ear or brainstem. Common symptoms of vertigo include nausea, vomiting, and tinnitus, which stem from the disrupted vestibular function and may occur due to conditions such as benign paroxysmal positional vertigo, Meniere's disease, or vestibular neuronitis.

While headaches can occur in a variety of neurological conditions, they are not a direct consequence of vertigo. Instead, they might indicate separate underlying issues such as migraines or tension headaches. Thus, while nausea, vomiting, and tinnitus are closely tied to the experience of vertigo, severe headache is not typically expected in contexts specifically associated with vertiginous episodes.