67-year-old female, day 7 post elective left common carotid stent placement , heparinised for visual disturbance day 1 post stent, complicated by large subdural and intra-parenchymal bleeds and refractory intracranial hypertension despite bilateral craniectomies. Clinical findings included sedation to control ICP, the presence of a femoral arterial puncture site, bifrontotemporal craniectomies and bilateral subdural drains, dilated unreactive pupils with absent corneal and oculo-cephalic reflexes and generalised hyporeflexia.
Candidates were directed to assess her neurological status and discuss what they would say to the next-of-kin.