DOCtalks

A 49yr old male, with prior medical history of PCKD, came to the OPD with the C/C of Severe headache, After the attack he developed weakness in his Rt. Arm. What is your provisional diagnosis?

Provisionally, we can say that as this patient has previous history of PCKD- so he is prone to develop aneurysms, there must be rupture of an aneurysm that has led to his symptoms.

Mx : Order a NCCT stat ➡️lumbar puncture to find xanthochromia ➡️ 4 vessel angiography (or noninvasive CT Angiography)

TX: Coiling or stenting to stabilise the aneurysm

First 24 hrs : prevent rebleeding by maintaining sys BP less than 15ommhg

Post 24hrs : Prevent vasospastic ischemia –

CCB (DOC: Nimodipine)