Question

Mandy 57-year-old female who fell and hit her head. Mandy states she did not lose consciousness. Mandy past medical history includes hypertension and diabetes- on oral medications for both conditions. Never smoked.   Admission vital signs: T- 98.8      P- 92     R- 20     BP- 132/94     Neuro exam: within normal limits

As you continue your assessment, Mandy is starting to have periods of confusion and becoming increasingly sleepy. Her neuro and vital signs are changing: BP- 186/64      P- 52 full and bounding     R- 14

Neuro exam: Ipsilateral fixed and dilated R pupil, small L pupil responds slowly to light

Mandy is having what possible neurological disorder?

What signs and symptoms did she have that helped you identify this neurological disorder?

If her condition worsened, what additional signs and symptoms might you see?

What are possible treatments for her condition?

Answer 1

1. Mostly it is a case of increasing intracranial haemorrhage

2, Incrasing BP....... with reducing pulse rate, sleepiness and confusion poor light reflex and dialated pupil which is fixed etc

3.

• sudden weakness, tingling, or paralysis in your face, arm, or leg, especially if it occurs on only one side of your body
• sudden onset of severe headache
• trouble swallowing
• trouble with vision in one or both eyes
• loss of balance and coordination, dizziness
• trouble with language skills (reading, writing, speaking, understanding)
• nausea, vomiting
• apathy, sleepiness, lethargy, loss of consciousness
• confusion, delirium

4.

Treatment within the first three hours of the onset of symptoms generally results in a better outcome.

Surgery can relieve pressure on your brain and repair torn arteries. Certain medications can help manage symptoms, such as painkillers to ease severe headaches. Drugs may be necessary to control blood pressure. If your doctor determines that you’re at risk for seizures, you may need to take antiepileptic drugs.

Long-term treatment will be needed to overcome symptoms caused by damage to your brain. Depending on your symptoms, treatment may include physical and speech therapy to help restore muscle function or improve communication. Occupational therapy may help you regain certain skills and independence by practicing and modifying everyday activities