A 50-year-old woman presents with sudden onset of severe headache, blurred vision, and confusion. She has a history of polycystic kidney disease. On examination, she is hypertensive with a blood pressure of 180/100 mmHg. What are the differential diagnoses and what are the next steps?
This patient's symptoms suggest a type of stroke known as a hypertensive hemorrhage, possibly related to her polycystic kidney disease, which can cause hypertension. Other possibilities include subarachnoid hemorrhage or hypertensive encephalopathy. The next steps would include stabilizing the patient, including controlling her blood pressure, and obtaining a noncontrast CT scan of the head to confirm the diagnosis.