Red flags
- Papilloedema, retinal haemorrhage
- Seizure, coma
- Focal neuro deficit
First steps
- ABCDE + arterial line
- GCS, neuro exam
- CT brain (exclude stroke/haemorrhage)
Key investigations
- CT/MRI brain
- U&E, urinalysis (haematuria, proteinuria)
- ECG, troponin
Differentials
- Ischaemic stroke
- ICH/SAH
- PRES
- Toxic/metabolic encephalopathy
Initial management
- Labetalol IV or nicardipine infusion
- Target MAP reduction 10-20% first hour
- Anticonvulsant if seizures (benzo → keppra/phenytoin)
- Admit ICU
Referral
- ICU + neurology
AI clinical assessment
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