ABSTRACT

The clinical presentation of spontaneous intracerebral hemorrhages (ICH) varies depending upon the location of the hemorrhage. We report a case of an elderly female that was admitted due to diffuse crampy abdominal pain, nausea, and vomiting with one day of onset. Her medical history included hypertension and no previous abdominal or pelvic surgery. Her abdomen was soft, nondistended, and mildly tender to palpation in all quadrants. Her vital signs were normal. Laboratory blood tests and urinalysis were within normal limits. An abdominal CT was unremarkable. On day two of hospital admission, she persisted with the symptoms and started presenting an acute confusional state. Her neurological examination showed hippus. A cranial CT scan showed left parietal hemorrhage. A loading dose of phenytoin was started and her clinical symptoms fully recovered. On the following days, she had good acceptance of oral diet and was discharged to home with phenytoin prophylactically.