Published 25 March 2009, doi:10.1136/bmj.b813
Cite this as: BMJ 2009;338:b813

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A woman with sudden headache followed by collapse

Daniel A Jones, specialist trainee 2, cardiology1, Fiona Walker, consultant cardiologist2, Neha R Chopra, foundation year 21, Walter Serino, consultant cardiologist1, Farhad Huwez, consultant physician1

1 Basildon and Thurrock NHS Trust, Basildon, Essex SS16 5NL, 2 The Heart Hospital, London W1G 8PH

Correspondence to: DA Jones danieljones@doctors.org.uk

The first 150 words of the full text of this article appear below.

A 41 year old woman was admitted with sudden onset of severe headache followed by collapse and decreased consciousness.

She had a history of frequent migraines but was not taking regular drugs. She was a non-smoker with no history of recreational drug use.

On admission her Glasgow coma scale was 7/15 (E1 V1 M5). Her pupils were unequal but reactive. Examination of her peripheral nervous system showed increased tone in all four limbs with brisk reflexes. Plantar reflexes were equivocal. Her blood pressure was 150/80 mm Hg, pulse was regular at 44 beats/min, and oxygen saturation was 99% on 10 l/min. Cardiovascular examination was normal. A respiratory examination was normal.

The patient was intubated. Computed tomography of the head excluded intracranial haemorrhage.

A lumbar puncture was performed, and cerebrospinal fluid was sent for analysis; it showed white blood cell count 0x106/l (reference range 0-5 (all lymphocytes, no . . . [Full text of this article]

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Computer Diagnosis
Micheal D Innis
bmj.com, 31 Mar 2009 [Full text]
A woman with sudden headache followed by collapse: read with caution!
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