A 27 years old man develops a sudden onset of headache shortly after taking cocaine in a nightclub. He collapses with a right-sided hemiplegia, and his level of consciousness rapidly deteriorates. On arrival, he is in coma, extending to pain, with no eye opening and no verbal response. His left pupil is fixed and dilated. What are the most important differential diagnoses?

Of the relevant differential diagnoses, it is important to rule out stroke, cerebral aneurysm or hemorrhage and cavernous hemangioma.

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This post was written by Omar Rifai