48/Male

Cc: severe headache 3 hours after sexual intercourse,

Then, complained of severe throbbing headache at occiput, then to the entire head
(+) vomiting
(+) LOC

Precipitating factors: Vascular injury to the brain

- Past history of stroke, PHYSICAL ACTIVITY
(e.g. leakage or rupture of
vague headaches aneurysm)
relieved by Paracetamol
- (+) Hypertension
- (+)
Hypercholesterolemia
- Increased intracranial pressure
- Dilatation of blood vessels
SEVERE HEADACHE
- Stretch in the dura mater

Interruption in the
blood flow to the brain
parenchyma

Impaired distribution
of oxygen and glucose
to the brain tissue

Tissue Hypoxia

Altered cerebral
metabolism

Decreased cerebral
perfusion

Brain Tissue necrosis

Clinical Manifestations: LOC, GCS 3, anisocoric pupils, very minimal eyelid movements to corneal
maneuver, + Doll’s eye maneuver, (-) grimace to pain stimuli, very minimal purposeless to
abnormal posturing movements of the limbs to pain, (+) Babinski reflex, bilateral