A 65-year-old patient diagnosed with a subarachnoid hemorrhage secondary to uncontrolled hy-pertension appears drowsy and confused with pronounced focal neurologic deficits. This symp-tomology would place this hemorrhage at which grade?
a. I
b. II
c. III
d. IV
ANS: C
With grade III, the patient experiences drowsiness and confusion with or without focal neuro-logic deficits and pronounced meningeal signs. With grade I, neurologic status is intact with mild headache and slight nuchal rigidity. With grade II, neurologic deficit is evidenced by cranial nerve involvement and moderate-to-severe headache with more pronounced meningeal signs (e.g., photophobia, nuchal rigidity). With grade IV, the patient is stuporous with pronounced neurologic deficits (e.g., hemiparesis, dysphasia) and nuchal rigidity.
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