A 68 year old lady presents with a worsening headache for 2 weeks, and mild disorientation for 2 days. There is no history of trauma. She was diagnosed with diabetes mellitus 10 years ago, which is uncomplicated and well controlled on metformin alone. She is not on any other drugs, and has an unremarkable family history.
There is a large, hyperdense, right-sided subdural collection with signs of recent bleeding. A midline shift of 10 mm is noted.
You realize that performing a lumbar puncture might not be a good idea.
The X-Ray of the skull appears completely normal.
INR: 1.0 (0.9-1.2) APTT: 29 sec (25-35) TT: 12 sec (11-15)