A 52-year-old male presents with severe
headache, nausea and vomiting. He also complains of double vision. On
examination, he was afebrile, his pulse rate was 120 beats per minute and his
blood pressure was 85/50. There was a complete ptosis of his right eye and the
right pupil was dilated and the eye was deviated inferiorly and laterally.
There was neck stiffness.
Hb 14.2 g/dL
Na 120 mmol/l
K 5.3 mmol/L
TSH 1.0 mU/L (0.4-5
Free T4 6 pmol/L
Serum cortisol 150
nmol/L (200-700 nmol/L)
In this patient
which one of the following conditions is most likely?
Cavernous sinus thrombosis
e) Brain stem stroke