20yr male came to ER wid history of sever headache on and off since 1 month.c/o vomitings 2episodes jus 1hour back.no h/o fever ,non HTN ,non DM no other comorbidities .pt is concious, coherent, pupils B/L NSRL, no photophobia BP:200/110 mmHg, pulse-90/min, spo2-98%in room air.,ECG -WNL .and his CT brain plain is as following ...what is the DX and MX??

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Plain CT brain look normal. What about the optic fundi? Recurrent episodes of headache with 200/ 110mmhg BP, first thing in Neurology exam the optic fundi. Young pt with head ache and high BP needs investigation to exclude vasculitis,PAN ,renal cause etc

Young boy With above symptoms think of Sobarachnoid bleed and av malformation Anuerism Controll pressure fast Give cerebral decongesant once Get mri and mr angio done This ct shows some whitish shadow along d falx.... not sure Renal atery doppler Ecg Fundus Rft 2 decho

@Dr. Polepally Praveen Kumar Do update with further investigations as suggested by @Dr. Sanjay Tarlekar

Yah Sure...
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MRI brain give antiepileptic drugs

Hypertensive encephalopathy with bilateral cerebral infarcts

I agree with Dr.S.Tariekar.

Sub dural hematoma

Accelerated htn with ?bleed
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It's like cerebral infact

I do had pt with same complaints n was having doubt but got d CT scan report as bilateral cerebral infact
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Sah suspected as per history not there in CT..Young hypertensive think of pheochromocytoma/ paraganglioma..Evaluate..Or NW reduce BP with available drugs

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