Another Headache

Nervous System & Special Senses

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This patient has presented acutely with a seizure and right-sided stroke. In addition, ophthalmoscopy shows bilateral papilledema, which is suggestive of a raised intracranial pressure (ICP) - most likely secondary to an intracranial mass lesion.\n\nHis preceding headache has sinister features and suggests that an underlying pathology has been present for some time.\n\nTherefore the differential diagnoses include an intracranial tumor complicated by acute bleeding, cortical venous sinus thrombosis (CVT), and intracranial infections such as CNS tuberculosis or fungal infections complicated by the development of hydrocephalus or raised ICP.\n\nHe needs urgent imaging of the brain. Computed tomography (CT) is suitable as an initial investigation as "}]}

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