[knockandhello]

Dont know if I'm in the right area but hope someone can help me.Work in ltc elderly lady with history of hypertension has cerebral peritoneal shunt in(for 26 years she says)c/o headache last night and this is what her b.p. was.Pulse around 116 irregular.Apart from headache which eased with 1 panadol as she requested she felt fine.Was her usual vague self with short term memory loss.Systolic is usually around the 90.Im just wondering if a bp like this is a concern .

[EricEnfermero]

Usually when you're concerned about a headache with a shunt, you're looking for signs of increased intracranial pressure. The number one symptom that might normally jump out at you would be altered mental status, but this lady is a special challenge since her baseline is altered.

Looking at the vitals though, I think you're ok. Although the BP can elevate with increased ICP, usually the pulse rate would decrease, not increase. Was the BP repeated? I'm betting that it was just high due to the headache.

[knockandhello]

well I repeated her BP about 4 hours later and it was about the same.think the dyastolic had gone down to 103 with systolic about 125.Checked her previous bps on record and they had been around 120/90 pulse around 90 mark.Shall have to wait till I go back to work to see how she is I suppose.Thanks for your response.

[gwenith]

I think that this lady might have other issues besides the shunt. You say her heart rate was 116 and irregular? Did anyone do an ECG (EKG for Americans) to see if she was in Atrial Fibrillation?