A 34-year-old woman with a medical history significant for tobacco and cocaine abuse is brought to the emergency department (ED) by a family member after a witnessed seizure. She is currently unarousable. Vital signs are: blood pressure 198/100 mm Hg, heart rate 62 beats/min, respiratory rate 8 breaths/min. Glasgow Coma Scale score is 6. She is immediately intubated and elicits bilateral extensor motor responses with bilateral dilated pupils at 5 mm. The ED physician decides to mechanically ventilate to hyperventilate her, and administers a dose of IV mannitol 25%. CT is shown below.
Besides controlling her blood pressure, which of the following therapies is most appropriate?
A. IV tissue plasminogen activator
B. Phosphenytoin bolus
C. Dexamethasone bolus
D. Placement of an external ventricular drain
中文翻譯：
患者女性，34歲，有顯著的菸草和古柯鹼濫用病史，在見證癲癇發作後被家庭成員帶到急診科(ED)。她目前無法喚醒。生命體徵為：血壓198/100 mmHg，心率62次/min，呼吸率8次/min。GCS評分為6。立即對她進行插管，引起雙側伸肌運動反應，雙側瞳孔散大，為5 mm。ED醫生決定對她進行機械通氣以過度通氣，並給予IV25%甘露醇。CT如下所示。