Severe Headache

Walking Thoughts

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  What is the mechanism of the bleed?

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  What is the patient’s GCS? Does the patient need airway protection?

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  Was the exam performed on sedation?

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  Are there signs of intracranial pressure (ICP) elevation or herniation? If so, have medical measures been initiated?

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  Is there intraventricular hemorrhage (IVH) or hydrocephalus that might require a ventriculostomy?

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  What is the blood pressure? Was this a hypertensive hemorrhage?

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  What is the patient’s medical history? Is there a history of brain metastases or vascular lesions?

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  Is the patient on any antiplatelet or anticoagulant medications? If so, have these been reversed?

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  Is the patient a candidate for surgical evacuation or decompression?

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  Does the patient have an advanced directive in place? Who is her healthcare agent?