Presents with complaints of the worst headache

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Reference no: EM133815736

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Chief Complaint: Presents with complaints of "the worst headache" with pain between his left eye and ear; blurred vision and periodic difficulty speaking. Onset approximately 45 minutes ago; BP at home 188/106, HR 98, oxygen saturation 98% on room air (self-monitored and reported). Physical Exam: Glasgow Coma Scale (GCS) on admission: 12 (Eyes: 3, Verbal: 4, Motor: 5); Non-verbal pain scale 5/8 (occasional grimace, restless, tense and guarding head, elevated BP and HR); neck stiffness noted; positive Brudzinski and Kernig signs suggesting meningeal irritation; VS: blood pressure 164/100, HR 110 reg, R 26 reg, oxygen saturation 98% RA, oral T 99 °F (37.2 °C); heart sounds S1S2, no murmurs or rubs; lungs clear all lobes; dark purple bruising around left eye extends eyebrow to mid-cheek and bridge of nose across to front of left ear Past Medical History: Uncontrolled hypertension, cannot afford medications after losing job; hyperlipidemia; 2 small hemorrhagic strokes 2 years ago, weakness right side improved with physical therapy; social drinking (3-5 ounces of wine per month); denies previous episodes of cerebral ischemia; sedentary lifestyle Family History: Both parents and one sister with atherosclerotic coronary disease; father died of myocardial infarction; sister type 2 diabetes mellitus and hypertension.

Reference no: EM133815736

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