MLA Domain 5 · Presentation

Head injury

4 conditions in Finalist present this way. Work down the list and ask what would separate each one from the next — that discriminator is the exam question.

classic presentation · 1

Raised intracranial pressure

Falling GCS, a new fixed dilated pupil, Cushing reflex → impending herniation; neurosurgical emergency

differential of the above · 3

Idiopathic intracranial hypertension

Progressive visual field loss / worsening papilloedema → sight-threatening, urgent ophthalmology

Meningitis

Non-blanching rash, septic shock, reduced GCS, focal signs/seizures, raised-ICP signs → do not delay antibiotics

Migraine

Aura + COCP (stroke risk → COCP is UKMEC 4); thunderclap or new focal/systemic features → exclude secondary causes (see