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Management of Patient Undergoing Embolization: Aneurysm/AVMs

  • Deepali Garg
  • Mariel ManlapazEmail author
Chapter
  • 22 Downloads

Abstract

A 42-year-old female is brought to the emergency department (ED) by paramedics. She was watching television at her house when she had sudden onset of headache and nausea followed by loss of consciousness. On her arrival in ED, she was drowsy but obeying commands, no other neurologic deficits. Pupils were equal and reactive. On chest auscultation, B/L basal rales were heard. Her vital signs were BP—212/108 mmHg, pulse—48/min, SpO2—94% with O2 6 L by facemask, temperature—36.8 °F. EKG showed T wave inversion with ST segment depression. A CT scan showed SAH in the right sylvian fissure with a right frontotemporal intraparenchymal clot. An angiogram was performed and showed right middle cerebral artery (MCA) aneurysm. Blood investigations showed Na—130 mmol/L, K—3.2 mmol/L, glucose—238 mg/dL, Hb—13 g/dL, WBC—18 × 109/L, platelets—300,000/μL. Toxicology screen was positive for cocaine. Patient had a smoking history of 20 pack-years. There was no other significant medical history.

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© Springer Nature Singapore Pte Ltd. 2020

Authors and Affiliations

  1. 1.Department of General AnesthesiaCleveland ClinicClevelandUSA

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