q- 34 y.o. male, presents to ER, CC is acute onset of R. body weakness, Diffusion weighted MRI was positive, shows small left frontal intraparenchymal hemorrhage. Within 24 hrs. of admission, pt.'s R. sided weakness began to disappear, in 7 days it completely resolved. On sixth day of hospitalization, pt. quickly lost consciousness and showed clonic movements starting on R. side and generalizing to his L. side.

Listen, movements stopped within 5 min., but he had residual R side weakness for 1 day. A head CT scan was unchanged fr. admission. The appropriate tx. to start is...?

1- Heparin
2- r-TPA
3- Lamotrigine
4- Phenytoin
5- Warfarin
6- Depakote
7- Urokinase


































a) Give Phenytoin. Naturally, do NOT anticoagulate since there IS AN INTRACRANIAL HEMORRHAGE. Focal seizures that secondarily generalize after an intracerebral or subarachnoid hemorrhage occur frequently and are appropriately treated w/ an antiepileptic drug like Dilantin.