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Posted on 7/2/17 at 6:48 am to Jim Rockford
quote:
This morning my mother had a very brief episode of mental confusion. She has had a TIA before and thought it was that but the ER doc didnt think so. Her BP had spiked pretty high. It is usually in the low normal range with medication.
She has been completely lucid since the one event and besides the BP, has no other symptoms except what she says is a sinus headache. Did not do any scans. He said her bloodwork looked good. Sent her home with Ibuprofen for the headache and instructions to see her internist next week. Did not seem concerned at all. He thought a viral infection might be causing the high BP. Curious to hear the thoughts of any medical pros.
Hypertensive encephalopathy vs small lacunar infarct. Given her headache, altered mental status and elevated BP, she should have gotten a CT scan of her head...I would have done a CTA to rule out an aneurysm. If she continues having headaches I would take her to a different ER.
Posted on 7/2/17 at 6:52 am to cajunangelle
quote:
quote:
But I would be more suspicious for a UTI than a TIA
^^^this.
If it was a UTI causing her AMS, then it wouldn't likely be transient.
Posted on 7/2/17 at 8:09 am to LSUERDOC
Jim where are you at that you would have to go to Shreveport
Posted on 7/2/17 at 8:46 am to LZ83
Closer to Alexandria but we have family in Shreveport so we requested to go there
Posted on 7/2/17 at 9:15 am to LSUERDOC
quote:
...I would have done a CTA to rule out an aneurysm.
A CTA for a brief episode of confusion.
Posted on 7/2/17 at 9:26 am to Parallax
quote:
A CTA for a brief episode of confusion.
I bet he's pretty young and new. We have a couple of those. The CT techs hate them.
Posted on 7/2/17 at 9:47 am to LSU alum wannabe
How about you clowns post up your credentials...
I am 46. I have been doing this a long time. And it wasn't just the confusion. Elevated BP and headache along with the confusion. The CT was certainly warranted.
I am not here to make the CT tech's life easier. They perform the study that I order regardless if they feel it isn't needed. They are lazy for the most part, and don't want to do any of the studies ordered.
I am 46. I have been doing this a long time. And it wasn't just the confusion. Elevated BP and headache along with the confusion. The CT was certainly warranted.
I am not here to make the CT tech's life easier. They perform the study that I order regardless if they feel it isn't needed. They are lazy for the most part, and don't want to do any of the studies ordered.
Posted on 7/2/17 at 9:52 am to LSUERDOC
You are absolutely correct. Not performing a CT in that setting with that history is begging for a lawsuit.
You rule it out.
You rule it out.
Posted on 7/2/17 at 9:58 am to LSUERDOC
quote:
Hypertensive encephalopathy vs small lacunar infarct. Given her headache, altered mental status and elevated BP, she should have gotten a CT scan of her head...I would have done a CTA to rule out an aneurysm. If she continues having headaches I would take her to a different ER.
has the OP updated yet?Posted on 7/2/17 at 11:09 am to Jim Rockford
Gotcha
Posted on 7/2/17 at 11:10 am to LSUERDOC
CTA Brain from the ER. C'mon man. Ct of the head. Then schedule CTA as outpatient.
ETA. But you are right I would have done it anyway. Lol
ETA. But you are right I would have done it anyway. Lol
This post was edited on 7/2/17 at 11:13 am
Posted on 7/2/17 at 11:48 am to LSUERDOC
quote:
How about you clowns post up your credentials...
Simmer down. I called you young. You should be happy. Not testy. I'm an ER nurse who has been at it a while.
Nobody chuckled at a CT. We chuckled at a CTA.
quote:
They perform the study that I order regardless if they feel it isn't needed. They are lazy for the most part, and don't want to do any of the studies ordered.
You showed your hand here. They hate you. For a multitude of reasons. Are you the kind of doc who orders $5,000 worth of tests while your arm is on the doorframe of the exam room.
Posted on 7/2/17 at 1:16 pm to LSUERDOC
I'd be willing to bet 180/75 was the lowest BP in the ER at that time.
Posted on 7/2/17 at 1:57 pm to cajunangelle
quote:
has the OP updated yet?
So far all the tests have come back fine. Arteries are clear, MRI shows no stroke. Neurologist is about 50-50 between a TIA and some kind of seizure. Having an echocardiogram and eeg to rule out anything they may have missed, if that comes back okay, they'll release her tomorrow. Said something about maybe starting her on Plavix but he hadn't decided yet. I guess she'll get referred for a full workup sometime soon.
Thankful she seems to be okay, but a little frustrating they haven't found a cause.
Posted on 7/2/17 at 2:07 pm to Jim Rockford
quote:
Thankful she seems to be okay, but a little frustrating they haven't found a cause.
Frustrating yes. Just keep in mind all they are looking for now is shite that you want no part of. Best of luck.
Posted on 7/3/17 at 8:20 am to LSU alum wannabe
Had another seizure this morning, observed by nurses and clearly a seizure, not a TIA. Started on Kepra.
Posted on 7/4/17 at 9:16 pm to Jim Rockford
Discharged from the hospital today. Diagnosis epilepsy of unkown origin. Still has some short memory gaps which I hope will clear up. The big thing is she cant drive for 6 months which is very disconcerting to her.
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