AF.17. Anvy Jacob - Ms. Maria Joseph

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15 May 2011

The Neurologist

Dear Doctor,

Re: Ms. Maria Joseph, aged 39

I am writing to request an urgent assessment for Ms. Joseph who suspected to have probable intraencial pathology, space occupying lesions.

Today, Ms. Joseph fell down at home due to severe left sided headache which was started 5 hours after reaching home after yesterday hospital visiting. She has injury on the right arm and bruises on left leg, slurred speech and is halfunconscious. Her vital parameters is elevated with BP of 150/90 and pulse 100. Her extension ppwer and left leg knee flexion is 4/5.

Initially, on 10 May 2011, Ms. Joseph presented with complaints of frontal headache nausea and blurred vision but not aura. Her vital signs were stable and was advised to take rest along with paracetamol 500 4th hourly.

Yesterday, Ms. Josepg represented with complaints of headache on left side and frontal, blurred vision throbbing headache of left side and had vomited along with slight paresthesia. Her vitals was same as on today and was administered with petnidin 100gm and intramuscular injection maxolon 10mg as she has the possibility of severe migrane.

In view of above, please do an emergency assessment of Ms. Joseph to find out her actual diagnosis.

If you have any queries, please donot hesitate to contact me.

Yours faithfully,

Head Nurse.

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