■ Neurosurgery consult
■ Especially for cerebellar hemorrhage, which is associated with rapid
deterioration and herniation
SUBARACHNOIDHEMORRHAGE
See “Headache.”
A 25-year-old male with a history of epilepsy presents with continous
seizure activity for >30 minutes. He weighs approximately 100 kg. His glu-
cose is normal and he has no history of alcohol use. There is no change in
seizure activity after two doses of lorazepam. What is the most appropriate next
agent?
Phenytoin IV is the most appropriate next agent. This patient also warrants
airway control via RSI.SEIZURESCAUSES
Seizures result from excessive and disordered neuronal firing. They may be a pri-
mary disorder or secondary to an underlying medical condition (see Table 15.5).
NEUROLOGYFIGURE 15.3. Noncontrast head CT demonstrating a large frontal intracerebral
hemorrhage.
(Reproduced, with permission, from Stone CK, Humphries, RL. Current Emergency Diagnosis
and Treatment, 5th ed. New York: McGraw-Hill, 2004:374.)