Case 24-1985: A 49-Year-Old Man with a Headache Followed by Collapse and Rapid Neurologic Deterioration

Presentation of Case A 49-year-old man was admitted to the hospital after collapse at work. He was reportedly well until three weeks earlier, when he fell and sustained a laceration of the right leg. A physician noted that his blood pressure was 150/90 mm Hg but prescribed no antihypertensive medication. During the next few days the laceration bled intermittently. His condition was apparently stable thereafter until three days before admission, when a severe occipital headache developed and was accompanied by pain in both temporomandibular joints. He took two aspirins every four hours, without relief of pain. On the day of.