65yr old ,M, Rt temporal head ache 5 days with left sided we | Figure 1

ray007

Anesthesiology Resident

65yr old ,M, Rt temporal head ache 5 days with left sided weakness developed on the 5th day of head ache. Head ache almost continuous ,vomited once on the 4th day of head ache.Evaluated locally , xray skull was taken and was given analgesics.Came to ER with left sided weakness.Slipped and fell down 2 months ago but not noted any injury and was able to get up immediately. Previous history of SDH evacuated 2 yrs ago

Examination Bp was 140/ 80 mmhg. 4/5 power on the left side with mild hyperreflexes with downgoing left plantar and intact sensations. Rt knee was hyperactive

Diagnosis and management.

Similar Cases

This is CT brain of a 58-year-old male patient presented to ER with recent acute confusional state, with right side weakness for the last 4 hours. He had a history of one-time headache and vomiting with generalized fatigue, possibly fever one day before, negative drug history. On examination, he was found to be conscious but confused and disoriented to place, time, persons. Vitally stable, BP is 160/90, no fever; neurological examination shows no weakness, power is 5/5 in both sides, UL, LL, normal reflexes, planter is equivocal right side, down going in left side, he has right upper limb involuntary movement resembling dystonia. Preliminary lab investigation unremarkable, brain MRI is pending. What could his diagnosis?

20-year-old male presents with numbness started 5 days ago in left hand. Over the next five days, the entire left side became numb, along with difficulty walking and hearing loss in left ear. See the mass.

48-year-old female, known DM, on medication, presented with right-sided weakness of 13 hours duration. Came after evaluation at local hospital. On examination, BP 120 / 80 mmhg. Global dysphasia, right sided flaccid weakness with grade 0 / 5 power; DTRs hypoactive with 0 plantar right side. Spontaneously moving left side with intact DTRs. What abnormality is in the brain?

76-year-old male, known hypertensive 12 years, CAD post angioplasty on Clopidogrel 75 mg along with anti-hypertensive and statin, presented with progressive left side weakness for 7 days. Denied having any headache, vomiting, or vertigo. On asking, he stated that approximately 5 weeks ago, he hit his head on the door which was very mild and he denied having any further symptoms. He came by walking. Examination showed normal higher mental functions with grade 4/5 power side, with hyperactive DTRs and mild dulling of sensation left side of the body. What abnormality is in the CT brain and what is the diagnosis?