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What is the most appropriate initial management?

a) CT head followed by administration of tPA
b) Discharge home with prednisone and taping of the eye shut at night
c) Magnetic resonance imaging of the brain
d) Stat neurology consult for neurointerventional procedure

User Lydia
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1 Answer

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Final answer:

For meningitis with optic nerve swelling, immediate medical attention is required. A stat neurology consult for a neurointerventional procedure is the appropriate initial management, not just prednisone and eye taping.

Step-by-step explanation:

The most appropriate initial management for a patient with signs of meningitis and swelling around the optic nerve would involve immediate medical attention. In cases where the inflammation from meningitis is severe enough to cause proptosis or lid retraction, it could be indicative of conditions like Graves' Disease, which requires specialized treatment.

The swelling related to meningitis can compress the optic nerve because the inflammation associated with meningitis occurs in the meninges, the protective layers of the brain and spinal cord, which are in close proximity to the optic nerve. This can lead to increased intracranial pressure and result in vision impairment or loss if not managed quickly and effectively. Therefore, discharging the patient with prednisone and advising to tape the eye shut at night is not sufficient in this scenario. A stat neurology consult for a neurointerventional procedure is the recommended course of action to address the underlying cause and reduce the risk of further damage to the optic nerve.

User Vinyl Warmth
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