You receive a prehospital stroke alert from ALS for a 73 yo male found down, minimally responsive. "Pretty routine" you think as you listen to report from the paramedic...that is, until you hear the vital signs: "Blood pressure is 270 over 140." That's the highest blood pressure you've ever heard of and you immediately begin to worry about how the human brain can possibly tolerate this as you head to the resuscitation bay to assemble your team...
A young female presents complaining of severe abdominal spasms intermittently over days. She has a known neurologic condition which you have never heard of before. Read on to learn the basics of this rare disorder and how to deal with acute exacerbations in the ED!
History: A 64-year-old woman presents to the ED via EMS after a witnessed seizure lasting less than 1 minute. The patient appeared post-ictal for EMS but is currently alert and oriented. She does not recall what happened.
Yes we learned most this as a 4th year med student... but sometimes reviewing the basics can remind us of some important details we've forgotten. That's what back-to-basics is for! Here we review different types of intracranial hemorrhages.
A 24 year old female presents to the ED complaining of a worsening headache after a lumbar puncture performed in the ED 2 days prior which diagnosed idiopathic intracranial hypertension. "No problem!" you think. Either this is just a post LP headache or possibly the patient needs more CSF drained to improve her headache. LP is a very safe procedure with minimal risk after all! Right?
Most patients presenting to the ED with a headache have a simple primary headache: tension, migraine, or cluster. Detecting the "other" etiolgies for headache, which can result in neurologic devastation or death, is often a diagnostic challenge. He we give some quick hits for one of the "can't miss" headaches, how it presents, and how to diagnose it.