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Case 18 

Case 18
Case 18

Harutomo Hasegawa

, Matthew Crocker

, and Pawan Singh Minhas

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date: 25 July 2021

A 49-year-old woman presented to hospital having suffered a sudden-onset severe headache 6 days previously. She felt nauseous at the time of the headache, although she did not vomit. The headache reached maximum intensity 24 hours after onset and then eased, but has persisted. Three days prior to admission she noticed that her left eyelid was drooping. She attended her general practitioner who arranged for her to be seen in the emergency department. On examination, she was alert and orientated (GCS 15/15). Her left eyelid was closed and she could not open it. When the eyelid was lifted, the left pupil was dilated and the eye was found to be looking down and out. No other neurological deficits were found.

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