Reference no: EM133334622

SCENARIO: ACUTE STROKE

Mrs. H.A., a 45-year-old female, is admitted to your unit with mental status changes. She came into the Emergency Department with complaints of having the "worst headache" of her life. She rated her pain a 10 on a scale of 1 (no pain) to 10 (worst pain ever). She also reports the following symptoms: nausea, vomiting, photophobia, and increasing drowsiness.

Her medical history consists of migraine headaches that she experiences monthly. She reports that this headache is much worse than her usual migraine headache. She takes a calcium channel blocker for hypertension that she developed 6 years ago. She is a smoker (one pack per day for 20 years) and she is obese. Currently she continues to complain of headache (10/10).

You perform a physical examination and you note that she has nuchal rigidity, a lopsided smile that gives her face an asymmetrical appearance most notable on the right side. Her vital signs are normal other than her BP, which is hypertensive at 165/90. Other than her headache, she is neurologically intact. She continues to experience nausea and vomiting along with her headache. The health care providers suspect a stroke.

1. What diagnostic test is indicated for this patient?

Clinical Update: Her CT scan reveals diffuse subarachnoid blood and enlarged ventricles.

2. What pathophysiology underlies this stroke?

3. Name the other type of stroke and discuss the pathophysiology that underlies this type.

4. What should be the priorities of her care?

5. In 3 days' time, what will she be at increased risk of developing?