SAQ. A 30-year-old woman presented with severe headache for 1 day and convulsions several times. She has a mild fever. On examination GCS- E2V1M4, BP-150/100 mmHg, pulse-62/min, temperature 100 degree F, mildly dehydrated. She has a history of NVD 19 days ago.
- What are the possible differentials?
D/D
- CVST
- Postpartum eclampsia
- TTP
- Meningoencephalitis
- Funduscopic examination reveals bilateral papilledema. What specific investigation do you want to do next?
- MRI of brain with contrast with MRV
- How will you treat her?
- General–
- IV fluid
- Temperature control
- Seizure control: IV antiepileptic
- Control of raised ICP: IV mannitol/ dexamethasone
- Specific
- For CVT:
- Anticoagulant with LMWH followed by maintenance warfari
- Endovascular thrombolysis
- IV antibiotic
- IV MgSO4 → in eclampsia
- Plasma exchange if TTP