TY - CHAP M1 - Book, Section TI - External Ventricular Drain Management and Ventriculoperitoneal Shunts A1 - Alexiades, Nikita G. A1 - Ellis, Jason A. A1 - Connolly, Jr., E. Sander A2 - Lee, Kiwon Y1 - 2017 N1 - T2 - The NeuroICU Book, 2e AB - A 64-year-old woman with a history of hypertension and hyperlipidemia presents with sudden onset headache and stupor. She is taken by ambulance to a nearby emergency department (ED); en route she is given 2 mg midazolam because of seizure-like activity. In the ED, the patient is minimally responsive to pain with a flaccid right arm and increased tone in her lower extremities and is subsequently intubated. Noncontrast head computed tomography (CT) demonstrates hyperdensity in the sylvian fissure and basilar cisterns and intraventricular hemorrhage (IVH). Her third and lateral ventricles are notably dilated. She is diagnosed with subarachnoid hemorrhage (SAH) with IVH and early hydrocephalus and is transferred to the neurologic intensive care unit (NeuroICU) for further management.On arrival to the NeuroICU she is examined with no sedation and is found to not follow commands. Her pupils are symmetrically reactive, and she moves her left side purposefully but is flaccid in her right upper extremity. Vital signs are heart rate, 90 bpm; respiratory rate, 18 breaths per minute; temperature, 37.4°C (99.4°F); and blood pressure, 120/73 mm Hg (Figure 22-1). SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/10/10 UR - neurology.mhmedical.com/content.aspx?aid=1143955479 ER -