Neuro

The case The patient is a 29-year-old female with a 3-month history of worsening headaches. She had a witnessed seizure 2 weeks ago which prompted her to seek care in the emergency room. A magnetic resonance image (MRI) done at that time was suspicious for an intracerebral arteriovenous malformation (AVM). This diagnosis was confirmed by a cerebral angiogram performed 4 days after the MRI. The patient is now scheduled for endovascular embolization of the AVM in the neuroangiography suite, and she presents to the preoperative clinic as an outpatient 2 days before her scheduled surgery. She reports that she is other wise healthy and denies tobacco, alcohol, or drug use. She has been taking phenobarbital 100 mg bid since her seizure. Patient care Residents must be able to provide patient care that is compassionate, appropriate, and effective for the treatment of health problems and the promotion of health. Gather essential and accurate information about their patients. Is there any other relevant medical history? This should include a full review of systems, a review of prior surgeries and anesthetic events, a review of the patient's medication regimen and allergy history, and a family history. A thorough physical exam must be completed and documented. Special attention should be paid to the airway exam as well as a neurological exam to discover and document any deficits that might be attributable to the AVM. Make informed decisions about diagnostic and therapeutic interventions based on patient information and preferences, up-to-date scientific evidence, and clinical judgment.