Presentation+ diagnosis deck Flashcards
A young man presents to A&E following trauma to the head. He blacked out for a minute, woke up, then felt fine but now has a worsening headache. He feels nauseous and has vomitted once. His GCS is rapidly declining. What do you think he may have?
An extradural haemorrhage
May also possibly be an acute subdural haemorrhage also
An elderly man presents to A&E with a worsening headache. He is a known alcoholic and fell down the stairs and hurt his head a few days ago. He says he feels slightly nauseous and as if he is fluctuating in and out of consciousness. What do you think might be wrong with him?
He may have a chronic subdural haemorrhage
A young man presents to A&E following trauma to the head. He blacked out for a minute, woke up, then felt fine but now has a worsening headache. He feels nauseous and has vomitted once. His GCS is rapidly declining. What should you do to investigate, what will you see and how would you treat your top differential?
Non contrast CT of the head, you will see a lenticular/ball shaped white area on the outer edge on the brain
If its an extradural haemorrhage refer him immediately to surgery
If its an acute subdural haemorrhage again refer him to surgery (they will drill burr holes and remove the haemorrhage)
An elderly man presents to A&E with a worsening headache. He is a known alcoholic and fell down the stairs and hurt his head a few days ago. He says he feels slightly nauseous and as if he is fluctuating in and out of consciousness. What should you do next to investigate, what will you see and how would you treat your top differential?
Non contrast CT of the head- there will be a crescent shaped mark on the outer edge of the brain, it may be white if the blood is fresh or dark if the blood is old
If there are neurological effects refer him to surgery
A 51 year old black woman comes into A&E complaining of the worst headache shes ever had localised at the back of her head near her head. She is a smoker and has a medical history of hypertension and diabetes. What do you think might be wrong with her?
She has a subarachnoid haemorrhage
A 51 year old black woman comes into A&E complaining of the worst headache she’s ever had localised at the back of her head near her head. She is a smoker and has a medical history of hypertension and diabetes. What should you do to investigate and what do you expect to see?
Non contrast CT of the head
Cisterns will appear white
An elderly man present to A&E with sudden loss of function, aphasia and headache. He has atrial fibrillation and high cholesterol. What do you think might be wrong with him?
He may have an ischaemic stroke
