While many patients have an altered level of consciousness coma is unusual

While many patients have an altered level of

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consciousness, coma is unusual. Seizures occur during the first 24 hours in less than 10 percent of patients but are a predictor of poor outcome. SAH may also present as sudden death; at least 10 to 15 percent of patients die before reaching the hospital.Subdural hemorrhage- presents with symptoms of elevated intracranial pressure including headache, vomiting, anisocoria, dysphagia, cranial nerve palsies, nuchal rigidity, and ataxia.The insidious onset of headaches, light-headedness, cognitive impairment, apathy, somnolence, and occasionally seizures,may occur as a consequence of chronic SDH, patient on anticoagulants, bleeding between the epidura and subarachnoid of the brain.Temporal arteritis-(Giant Cell)The cause of the blood vessel inflammation is unknown. In some cases, the swelling affects just part of an artery with sections ofnormal vessel in between. Symptoms include acute onset of headaches located on one temple, skin over artery is indurated, jaw pain, vision loss, fever, and weight loss, anorexia, fatigue. Dx usually requires biopsy of the temporal artery. Elevated
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sed rate and c reactive protein, high risk with polymyalgia rheumatica, the condition needs prompt treatment with steroid medications to prevent permanent vision loss. TX prednisone, methyl prednisone, aspirin nsaids, refer to ophthalmology and rheumatologistoQuestion about Migraine headache: Know the description and duration of headaches as wellMigraines:Headaches last 4-72hours. Unilateral, pulsating, mod to severe, aggravated by routine activity. n/v, photophobia, phonophobia. Imitrex,(Sumatriptan 5-HT-1) Immediate, prophylactic, Beta blocker, TCA, amitriptyline,colcholineMigraine with aura: metallic taste, hyperosmia(smell), blurred vision all prior to headache. NO COMBINATION BIRTH CONTROL PILLSCluster headaches- occurs at time/night last 15 to 180 minutes, severe ice pick lacerating pain, unilateral behind the eye or temporal pain accompanied by same side of the face sweating, lacrimation, nasal congestion, ptosis, rhinorrhea, eyelid edema, produce red teary eye, common middle aged-manTX O2, Imitrex, CCBfor prophylaxis, resolve spontaneouslyTension headaches- last several days mild to moderatebilateral no pulsating pain, tightening pain that is not aggravated by physical activity, with no N/V or photosensitivity, spasms of trapezius muscle TX Nsaids, stress reductionEssential tremor-inherited tremor treat with propranolol or atenololCataracts- opacity in lens, difficulty with glare, halos around light, blurred vision, gradual onset of decreased night vision, red reflex disappears (Red reflex is now opaque gray instead of orange red glow) COMMON CAUSE OF BLINDNESS DEVELOPING COUNTRIESMacular degeneration- loss of center vision, loss of visual acuity, contrast sensitivity but still have peripheral vision, may find Drusen bodies, Dx Amsler grid to evaluate central vision changes COMMON CAUSE OF BLINDNESS IN UNITED STATESRetinal detachment-
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