Vascular | |
Intracerebral bleed | • History of preceding sudden onset headache |
Subarachnoid haemorrhage | • Focal neurological signs |
Stroke | |
Metabolic | |
Hypoglycaemia | • History of diabetes mellitus |
Severe hyperglycaemia | • Always check the glucose |
(hyperosmolar non ketotic coma) | |
Severe hyponatraemia | |
Poisoning | |
Opiates | • History of illicit drug use, alcoholism or mental health problems |
Tricyclics | • Presence of empty pill bottles |
Benzodiazepines | • Pin-point pupils (opiates) |
Carbon monoxide (accidental or deliberate) | • Dilated pupils (tricyclics or benzodiazepines) |
Alcohol | |
Head injury | • History of falls |
| • Scalp laceration, bruising or swelling |
| • Periorbital bruising |
Epilepsy | • Previous history of fits |
Status epilepticus (non-convulsive) | |
Postictal | |
Infection | • History of prodromal illness |
Meningitis | • Rash |
Encephalitis | • Pyrexia |
Sepsis | • Signs of septic shock (peripheral vasodilatation, tachycardia, hypotension) |
Hypothermia | • Temperature <35°C |