A person developes altered sensorium following head- ache and vomiting, Diagnosis is
(B) Subarachnoid hemorrhage # In SUBARACHNOID HAEMORRHAGE, sudden loss of consciousness may be preceded by a brief momment of excruciating headache. The headache is usually generalized, & vomiting is common. In intracerebral haemorrhage. focal deficit typically worsen steadily over 30-90 min & is associated with a diminishing level of consciousness & signs of raised ICT. such as vomiting & headac> In cases of epilepsy. the postictal phase is characterized by unresponsiveness. muscular flaccidity & excessive salivation that can cause stidorous breathing & partial airway obstruction.> Bladder, bowel incontinence may occur at this point as well. Patients gradually regain consciousness over minutes to hours & during this transition, there is typically a postictal fatigue & muscle ache can last for many hours.> In Botulism, there is symmetric descending paralysis & can lead to respiratory failure & death> Cranial nerve involvement, which almost always marks the onset of symptoms, usually produces diplopia, dysarthria & dysphagia. Patients are generally alert & oriented, but they may be drowsy, agitated & anxious.> Hysteria may present in any way. But in this condition, there is lack of any positive physical findings. From the above discussions, now it is clear that altered sensorium following headache & vomiting is diagnostic of subarachnoid haemorrhage (SAH).
Intracerebral hemorrhage
Subarachnoid hemorrhage
Hysteria
Botulism
Miscellaneous