Classic #Subarachnoid-hemorrhage pattern #SAH | Figure 1

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Classic #Subarachnoid-hemorrhage pattern #SAH

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#brain #Hemorrhage presented with 3 days of extreme dizziness and headaches. Right temporal lave hemorrhage 5.4 x 3.5 x 4.5. Had a prior hemorrhagic CVA on the left 6 years ago. Encephalomalacia evident on current scan.](https://app.figure1.com/case-detail/419b3e76-9a93-43e0-8d5b-583ee260815d)



stumbled upon this little gem today in my travels. Lumbar fx](https://app.figure1.com/case-detail/4da1a54a-c61c-4f9b-bcfb-802adcd9f0e4)



A 23-year-old female with no significant medical history presented to the ED with a severe headache, described as the worst headache of her life. The headache came on suddenly three hours earlier while sitting, involved her entire head, and was rated at a level of 10 (on a scale of 0 to 10). She reported associated nausea, vomiting and sensitivity to light, but denied neck stiffness, fevers or chills, visual changes, focal weakness,numbness or trauma. She had not experienced such headaches in the past and denied illicit drug use. Her only medication was oral contraceptives Her last normal period was two weeks earlier.
PHYSICAL EXAMINATION
GENERAL APPEARANCE:
The patient appeared well nourished, well hydrated, lethargic and in acute discomfort.
VITAL SIGNS
Temperature 97.9
Pulse 94 beats/minute
Blood pressure 118/69 mmHg
Respirations 18 breaths/minute
Oxygen saturation 100% on room air
HEENT: PERRL, EOMI, no nystagmus, moderate photo-phobia
NECK:
Supple, no meningeal signs.
CARDIOVASCULAR:
Regular rate and rhythm without rubs,murmurs or gallops.
LUNGS: Clear to auscultation bilaterally.
ABDOMEN: Soft, nontender, nondistended.
EXTREMITIES: No clubbing, cyanosis or edema.
NEUROLOGIC: Somnolent but easily arousable, oriented to person, place and time. Cranial nerves II-XII grossly intact;upper and lower extremity strength 5/5 bilaterally, proximal and distal. Sensation grossly intact, no pronator drift, no dysmetria on finger-to-nose testing.
A peripheral intravenous line was placed, blood was sent forlaboratory testing, and a noncontrast CT of the brain was obtained. The patient was given morphine sulfate and Zofran IV for pain and nausea, respectively. Laboratory tests, including a complete blood count, electrolytes,creatinine, glucose and coagulation studies, were within normal limits. A serum pregnancy test was negative.
What is your DDx? Management?](https://app.figure1.com/case-detail/5d76e0d3-7f7d-46bc-8530-742929a3671e)



Spread MRI scans of patenta, CT-scans which were posted recently. MRI confirmed the tumor vasogenic swelling, dislocation](https://app.figure1.com/case-detail/5f39de39-becb-4f84-aa84-b65e318ef745)



A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis.
He had a history of hypertension, long-term smoking, and a sedentary lifestyle.
On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.](https://app.figure1.com/case-detail/ae0fe999-6875-4474-94f0-ad823dbb9b3a)



A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets.
Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.](https://app.figure1.com/case-detail/c271070f-2bc7-4052-9895-635277e1a7d5)



A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.](https://app.figure1.com/case-detail/48f41642-b9db-4089-b120-a94ee52328de)



patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?](https://app.figure1.com/case-detail/2af390e1-ace8-40ed-ba1c-98fb2d72f4c5)