Challenger Medical Education Blog

A 62-year-old woman was hit by a ball while playing tennis

Written by Med-Challenger | Nov 25, 2024 5:53:14 PM

A 62-year-old woman with no previous medical history was hit by a ball while playing tennis. Seconds after the impact she had a popping sensation in her nuchal area followed by intense headache. She was heard saying, "This is the worst headache of my life." She then became confused and began vomiting. She was taken to a local hospital where computed tomography revealed significant subarachnoid hemorrhage and early hydrocephalus. She was noted to be hypertensive with a blood pressure of 215/110 mm Hg.

The patient was transferred to the intensive care unit and a neurosurgical consult was placed. Intravenous labetalol and phosphophenytoin were started and the patient was intubated for airway protection.

What therapeutic action will be most effective in decreasing intracranial hypertension in this patient?

  • ventriculostomy
  • elevation of the head of the bed to 30 degrees
  • glucocorticoids
  • propofol infusion

 

This question appears in Med-Challenger Internal Medicine Exam Review with CME

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