Certified Neuroscience Registered Nurse (CNRN) Practice Exam

A patient experiencing a severe right-sided headache and transient ipsilateral blindness should be monitored for?

1. Transient ischemic attack

2. Partial Horner's syndrome

3. Intracranial hemorrhage

4. Aneurysmal rupture

The correct answer is: Partial Horner's syndrome

The scenario presented involves a patient with a severe right-sided headache and transient ipsilateral blindness. When considering these symptoms, monitoring for partial Horner's syndrome is particularly relevant due to the involvement of the sympathetic nerve pathways that are located in the neck and upper thorax. Horner's syndrome can manifest with symptoms such as ptosis (drooping of the eyelid), miosis (constriction of the pupil), and anhidrosis (lack of sweating on the affected side). The occurrence of a severe headache could suggest a disturbance in the vascular or neurologic pathways that might affect the sympathetic nerves supplying the eye and surrounding structures. The transient ipsilateral blindness indicates a possible transient reduction in blood flow to the optic nerve or the systems supplying that area, which could involve the sympathetic nervous system, and thus, the close association between headache and a possible disturbance leading to Horner’s syndrome makes monitoring for this condition particularly relevant. In contrast to other potential conditions like transient ischemic attacks or aneurysmal rupture, which may also cause severe headaches, they do not specifically indicate a relationship to the symptoms of ipsilateral blindness and would present with a wider array of neurological deficits. Monitoring for intracranial hemorrhage, while important in the context of severe