Kamsi
Forum Guru
Topics: 103
Posts: 347
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A 29-year-old computer programmer is brought to the emergency department by friends after he suddenly falls to the ground at a party. He has severe headache, photophobia, and vomiting. He has no significant medical history. On examination, blood pressure is 210/110 mm Hg; pulse rate, 110/min; respiratory rate, 22/min; and temperature, 37.2 C (99 F). He is in moderate distress from headache. He has moderate meningismus but no focal neurologic findings. Routine laboratory tests are normal. Urine drug screen is positive for cocaine. Computed tomography of the brain shows a moderate-sized left thalamic hemorrhage with some intraventricular extension of blood. The patient is stabilized and his blood pressure is controlled with intravenous nicardipine. He is admitted to the intensive care unit for monitoring.
What additional diagnostic testing is most appropriate?
A. None
B. Electroencephalography
C. Echocardiography
D. Cerebral angiography
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| darkhorse
Forum Elite
Topics: 56
Posts: 275
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DDDDD...
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| guangyu
Forum Elite
Topics: 29
Posts: 308
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A
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| sprint123
Forum Guru
Topics: 129
Posts: 870
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mm..Tricky....Intracranial haemorrhage in a young patient NECESSITATES cerebral angiography to rule out AVM....But, given the tox screen positive for cocaine, Can we consider cocaine as the cause of Intra-ventricular haemorrhage.
I go with CT angiography---Interested to know the answer
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| drdg
Forum Senior
Topics: 31
Posts: 176
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I go for D to rule out aneurysm.
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| neuroblastoma
Forum Guru
Topics: 99
Posts: 1,011
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me too would go for D (angigraphy to rule out AVM, aneurysm can cause Intracerebral hemorrhages.
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