2min read - Hyponatremia
A 75 years old female patient known to have hypertension for 10 years admitted with a progressively deteriorating level of consciousness for one day. There was no history of fever, headache, vomiting, diarrhea or trauma. Her medication included aspirin, losartan, HCT and atorvastatin. Examination revealed a GCS of 9 with no focal neurological deficits. She was mildly dehydrated. Her blood pressure was 140/90 mmHg. Respiratory and abdominal examinations were unremarkable. What are the possibilities? Intracranial vascular events (Stroke/ hemorrhage) less likely in the absence of focal neurological deficits Infections - Meningitis/ encephalitis Absence of fever and meningism is against, but elderly patients can present without those symptoms Seizures Nonconvulsive status epilepticus Prolonged postictal drowsiness Metabolic derangements Hypoglycemia Particularly hyponatremia List down a few more possibilities. RBS was 127mg/dl. Urgent non-contrast CT of the