Problem
Case Study:
Mr. D.S. is a 35-year-old male who arrived via ambulance to the emergency department after a sudden loss of consciousness. Pertinent history includes hypertension and obesity. The client's wife reported that he recently stopped taking the medications prescribed for his hypertension because he didn't like the way they made him feel. Mr. D.S. is a pack per day cigarette smoker who has tried to quit on multiple occasions. He drinks about six beers every weekend and has a remote history of cocaine use.
Starting earlier in the day he was complaining of a severe headache and took Tylenol which didn't seem to help. Despite the headache, he began mowing the lawn. Mrs. S. was watching through the window and noticed that the client stopped suddenly and collapsed to the ground. She immediately called 911.
On arrival to the emergency department, Mr. D.S. had a Glasgow Coma Scale score of 4. A computed tomography (CT) scan shows a subarachnoid hemorrhage with evidence of left parietal and frontal ischemia.
Tasks:
A. Describe the relationship of subarachnoid hemorrhage and tissue ischemia found on CT scan.
B. What risk factors are present in this client's history which may have caused the subarachnoid hemorrhage?
C. Provide 6 specific clinical manifestations that would be expected as it relates to the location of ischemia of the brain tissue?
D. What neurological complications related to subarachnoid hemorrhage are likely for Mr. D.S.?
E. What is the morbidity and mortality associated with subarachnoid hemorrhage and cerebral ischemia?
F. What is Cushing's triad and the pathophysiology for each component?