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blood >1 mm thick.Page 38 Page 39 Clinical Red Flags • Worst headache of life, acute onset. • Increase with exercise or sexual activity. • Mental status disturbances with agitation, confusion, and loss of consciousness. • Nausea and vomiting. • Focal neurologic signs, nuchal rigidity, CN disturbances, nystagmus, papilledema, retinal hemorrhages. • Weakness

blood >1 mm thick.Page 38 Page 39 Clinical Red Flags • Worst headache of life, acute onset. • Increase with exercise or sexual activity. • Mental status disturbances with agitation, confusion, and loss of consciousness. • Nausea and vomiting. • Focal neurologic signs, nuchal rigidity, CN disturbances, nystagmus, papilledema, retinal hemorrhages. • Weakness

blood >1 mm thick.Page 38 Page 39 Clinical Red Flags • Worst headache of life, acute onset. • Increase with exercise or sexual activity. • Mental status disturbances with agitation, confusion, and loss of consciousness. • Nausea and vomiting. • Focal neurologic signs, nuchal rigidity, CN disturbances, nystagmus, papilledema, retinal hemorrhages. • Weakness

preserved. Basic blood and urine analyses were normal. CSF was notable for elevated protein

preserved. Basic blood and urine analyses were normal. CSF was notable for elevated protein

preserved. Basic blood and urine analyses were normal. CSF was notable for elevated protein

blood, that he helplessly rolled away from the wreck he had made; lay panting on his side, impotently flapped with his stumped fin, then over and over slowly revolved like a waning world; turned up the white secrets of his belly; lay like a log, and died

blood-dripping head hung to the Pequod’s waist like the giant Holofernes’s from the girdle of Judith. When this last task was accomplished it was noon, and the seamen went below to their dinner. Silence reigned over the before tumultuous but now deserted deck

preserved. Fig. 7.1 Oligosymptomatic CADASIL with nonspecific hyperintensities in white matter. (A and B) Brain MRI, axial FLAIR, shows mild insular atrophy (arrowheads) with confluent bilateral hyperintensity of periventricular white matter (arrows) extending into internal and external capsules. CADASIL, Cerebral autosomal dominant arteriopathy with subcortical infarcts

preserved. Fig. 7.1 Oligosymptomatic CADASIL with nonspecific hyperintensities in white matter. (A and B) Brain MRI, axial FLAIR, shows mild insular atrophy (arrowheads) with confluent bilateral hyperintensity of periventricular white matter (arrows) extending into internal and external capsules. CADASIL, Cerebral autosomal dominant arteriopathy with subcortical infarcts