head trauma

Question 1

6. a previously healthy 51 years old african american woman present to the emergency department two hours after the sudden onset of severe generalized headache, she has a significant history of smoking but does not report history of hypertension. on physical examination, the blood pressure is 194/105 mmHg, HR 100 per minute, RR 20 bmp, temperature 37.5 C, oxygen saturation 97% on room air by pulse oxymetry. a neurological exam is normal although she prefers to keep her eyes closed due to photophobia. an emergent CT scan without contrast enhacement is performed. the most likely diagnoses is:

A. intracerebral hemorrhage
B. acute meningitis
C. subarachnoide hemorrhage
D. subdural hemorrhage

heart rate 200/min

Answer 1

correct answer C. the head CT scan done with the contrast enhancement reveals hypersensitive in the subarachnoid space in the ventricles. for this figures making a diagnosis of subarachnoid hemorraghea . In this
this is a typical presentation of a non traumatic subarachnoid hemmorhaea due to a cerebral aneurism rupture. this disease is more common in females where the ratio is 2:1 from female to male. usually this hapen in the 40’s and 50’s decades of life. Now, risk factors for SAH include smoking, arterial hypertension and prior aneurism rupture. the most common is headache followed by changes in mental status, cranial nerve abnormalities, and focal motor and language abnormalities.