Date | |||
---|---|---|---|
Past medical history | |||
22-7-2017 | 35-year-old female, who was previously healthy, and has positive family history of stroke at a young age | ||
Summaries from initial and follow up visits | Diagnostic testing | Intervention | |
22-7-2017 | Throbbing headache for the past 2 days Diagnosed as migraine | None was obtained | Analgesics: diclofenac injection, discharged on oral ibuprofen. |
23-7-2017 05:00 | The same headache that continued for 3 days | CBC, RFT, LFT, PT, PTT, and INR: within normal range; Plain CT of the head: hyperdense area in the SSS; CVST | |
23-7-2017 09:00 | CT of the head with contrast confirmed the diagnosis of CVST | Admission to a regular ward; LMWH | |
23-7-2017 06:30 | Decrease level of consciousness Talking, a few words inappropriately | Repeat plain CT head scan: third ventricular hemorrhage and deep venous thrombosis | Elective intubation; ICU admission; continue LMWH; EVD insertion (a few hours later) |
25-7-2017 | The same condition; no improvement | Repeat CT head scan: hydrocephalous and increasing edema and new ischemic areas | Brain decompression |
31-7-2017 | Left pupil dilatation | CT head scan: large hemorrhage | Evacuation, enoxaparin switched to unfractionated heparin |
To date | In the ICU; on tracheostomy with mechanical ventilation; in a permanent vegetative state; need for long-term care | – | – |