| Decrease Responsiveness with Headache and Nausea -
08-06-2007, 11:13 AM
CLINICAL BACKGROUND
62-year-old Alcoholic Woman presented to KMH, ER with decreased level of consciousness since 2 days with a chronic h/o of headache since 1 yrs back. Patient party denies any h/o seizure and vomiting, but the patient is complaining of Nausea since pt has developed this illness. She has h/o of fall 2 weeks back from Bed. She denies h/o DM but has h/o Controlled HTN under medication Tab Amlodipine 2.5mg. No other Past medical h/o and Surgical h/o.
Personal h/o : Alcoholic, Ex Smoker left 2 yrs back 4/5 cig /day in past
On Examination :
Patient was agitated, GCS : 12/15; E3 V4 M5 ;
Vitals : Bp : 150/90 mm Hg, Ps = 87/min, T= 98.9 F,RR = 22 /min
B/l pupils 3 mm sluggish reaction to light.
Chest / CVS / P/a = Reveals no abnormality
Laboratory Examination :
TC : 10,100/mm3 N 72 % L 28 % , Hb = 10.1 gm %, ESR = 18 ; Trop I -ve
Platelets : 1,75,000/mm3, PT : 14 sec , INR = 1
LFT, RFT, RBS, Na /K = WNL
ECG : LVH
Immediate nonenhanced computed tomography (CT) scan of the patient’s head done whichs shows : see images
What is the diagnosis, and what is the Mx in ER & further intervention is indicated ?
( if u find CT scans a bit problematic in terms of quality of picture , please tell me : pictures haru mobile bata liyeko bhayera yesto poor quality ko ho )
remember that silence is sometimes the best answer
Last edited by JNUS : 10-06-2007 at 10:19 AM.
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