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17th September 2024
A 55-year-old male presents to the emergency department with sudden onset of headache, nausea, and vomiting
A 55-year-old male presents to the emergency department with sudden onset of headache, nausea, and vomiting. He also experienced dizziness, lethargy and on examination, has features of 3rd, 4th, and 6th cranial nerve palsies. Blood tests and an MRI head are performed with the results shown below:
| Sodium | 131 mmol/l |
| Potassium | 4.3 mmol/l |
| Urea | 4.0 mmol/l |
| Creatinine | 56 μmol/l |
| Morning Cortisol | 74 µg/dl |
| Free T4 | 0.27 mIU/l (0.27-4.20) |
| Serum TSH | 11 pmol/l (12-22) |
Which of the following is the most likely diagnosis?
Select the SINGLE most appropriate option from the list below. Select ONE option only.
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