A 35 year old man is admitted to the Accident and Emergency department after being found fitting outside a nightclub. On arrival he is no longer fitting, but has a partially obstructed airway, oxygen saturations of 91% on air, heart rate of 91 beats per minute and a blood pressure of 160/90. He is unconscious, but groans to painful stimulus and his left pupil is fixed and dilated.
What is the likely cause for this clinical picture?
Is there likely to be any underlying pathology?
What is your approach to the management of this patient?
Many thanks to Dr Ed Mellanby for this case. Dr Mellanby will be moderating the discussion in the classroom this week, so be sure to add your thoughts.