A 24-year-old woman is brought to the emergency department 30 minutes after a seizure. The patient had an uncomplicated spontaneous vaginal delivery 10 days ago and was discharged from the hospital 2 days after delivery. She has had worsening headache for the past several days, which is most severe upon awakening in the morning and is associated with vomiting. Today, she experienced a brief generalized tonic-clonic seizure that was witnessed by her husband. She has no history of seizure disorder or other medical conditions. Family history is significant for recurrent deep venous thrombosis in her mother. Temperature is 37.1 C (98.7 F), blood pressure is 105/70 mm Hg, and pulse is 90/min. On physical examination, the patient is somnolent but arouses to voice and follows instructions. Pupils are normal but there is bilateral papilledema. There is no focal weakness or sensory loss. There is no neck stiffness. A noncontrast CT scan of the head reveals no intracranial hemorrhage or mass lesions. Blood cell counts, serum electrolytes, and liver function studies are within normal limits. Urinalysis is normal. Which of the following is the best next step in management of this patient?

Question

A 24-year-old woman is brought to the emergency department 30 minutes after a seizure.  The patient had an uncomplicated spontaneous vaginal delivery 10 days ago and was discharged from the hospital 2 days after delivery.  She has had worsening headache for the past several days, which is most severe upon awakening in the morning and is associated with vomiting.  Today, she experienced a brief generalized tonic-clonic seizure that was witnessed by her husband.  She has no history of seizure disorder or other medical conditions.  Family history is significant for recurrent deep venous thrombosis in her mother.  Temperature is 37.1 C (98.7 F), blood pressure is 105/70 mm Hg, and pulse is 90/min.  On physical examination, the patient is somnolent but arouses to voice and follows instructions.  Pupils are normal but there is bilateral papilledema.  There is no focal weakness or sensory loss.  There is no neck stiffness.  A noncontrast CT scan of the head reveals no intracranial hemorrhage or mass lesions.  Blood cell counts, serum electrolytes, and liver function studies are within normal limits.  Urinalysis is normal.  Which of the following is the best next step in management of this patient?

Quizplus · Accepted Answer

The Answer is C

A 24-Year-Old Woman Is Brought to the Emergency Department 30