cms NEURO block1 - cathywx

[ArchivalUser]

previously healthy 32 year old woman has the abrupt onset of a severe bi frontal headache, nausea, and vomiting, and diplopia 24 hours after an uncomplicated vaginal delivery of a healthy 3176-g newborn. She also has ha difficulty breast-feeding. She is drowsy but opens her eyes and moves all extremities to command. Her temperature is 37, pulse 110, RR 15, BP 115/60. Examination shows bitemporal heminopia and weaknss of the lateral rectus muscles bilaterally. The Right pupil 5mm, reacts sluggishly to light directly and consensually, the left pupil is 3mm and reactive. There is mild papilledema bilaterally and no meningismus. She is oriented to person and place but not to time. Which of the following is the most likely diagnosis?
a. brain stem infarction
b. migraine
c. pituitary apoplexy
d. saggital sinus thrombosis
e. SAH

How to tell it's not D?

thank you.