sergey1987apr
Forum Newbie
Topics: 4
Posts: 24
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A patient with the following "very limited" history:
Patient (70y.o. lady) presented to the accident and emergency department, with a history of "Coma-Producing Headache". On presentation, she was well alert, still suffer from headache and nausea, vital signs stable, no focal neurological deficit.
This is all that is given. I know many parts are missing but the question is set like this 
I know there are lots of ddx, but I want to differentiate between Subarachnoid hemorrhage, and epidural hemorrhage.
Q: Will SAH cause a coma and after that the patient spontaneous recover and be conscious, able to walk, GCS15/15, etc?
Q: Can this be lucid interval of EDH? Though in the very limited history there isn't any trauma or head injury?
Thanks a lot. 
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| nyimalay
Forum Elite
Topics: 9
Posts: 279
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Without a history of head injury, we shouldn't go for EDH.
Yes SAH can cause coma.
Sudden rise in ICP can cause sudden severe headache and coma (in up to 50% of patients according to Kaplan).
Then as the bleeding stop, patients can become stable with no neurological deficit apart from some headache due to meningial irritation.
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| sergey1987apr
Forum Newbie
Topics: 4
Posts: 24
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thank you vy much for ur explanation =)
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