MRCP2-3028

MRCP2-3028

A 70-year-old man is brought to the emergency department after a fall. His daughter found him unresponsive on the floor after hearing a loud noise. The patient’s daughter reports that he has been unsteady on his feet for the past few days and is recovering from a urinary tract infection. The patient has a medical history of benign prostatic hyperplasia and atrial fibrillation, for which he takes tamsulosin, finasteride, and rivaroxaban.

Upon examination, the patient is drowsy with a GCS of 12 (E3V4M5). His heart rate is 85 bpm, and his blood pressure is 210/118 mmHg. His chest is clear with normal heart sounds upon auscultation. Oxygen saturations are 90% on air. The patient has a deep laceration over the left side of his forehead, which is oozing blood, and there is bruising down the left side of his body. Pupils are equal and reactive to light.

A CT scan of the head reveals evidence of a moderate intracranial hemorrhage in the left frontal lobe, with no evidence of a mass effect.

What is the most appropriate next step in managing this patient?