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Dizziness With Syncope And Fall


Consult Page

77 year old woman with syncope and fall 3 days ago with intracranial bleed on CT

Initial Imaging

Figure 2.1, Axial (A), coronal (B), and sagittal (C) views of a head CT without contrast shows a small right parietal subarachnoid hemorrhage without evidence of skull fractures or mass effect.

Walking Thoughts

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    What was the etiology of her syncopal event? Why is she presenting 3 days after the fall?

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    What is the patient’s baseline functional status and neurological exam?

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    What is her current neurological exam?

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    Is the pattern of the subarachnoid hemorrhage concerning for an underlying aneurysm or vascular abnormality?

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    Does the patient take any anticoagulation? If so, have reversal agents been given?

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    Are coagulation labs available or pending?

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    Are there additional cervical spine or traumatic injuries that must be considered?

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