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A 67 years old man presents with rapid onset of right-sided weakness and a subjective feeling of decreased sensation on his right side. His family reported that he seemed to have difficulty forming sentences. Symptoms were maximal within a minute and began to spontaneously abate 5 minutes later. On arrival, 30 minutes after onset, his clinical deficits had largely resolved with the exception of a subtle weakness of his right hand. His history is significant for hypertension, diabetes, hyperlipidemia, and a 50 pack-year smoking habit. What are the most important differential diagnoses?

December 26, 2020 8:18 am Published by

Of the relevant differential diagnoses, it is important to rule out stroke, brain tumor, aneurysm, intracerebral hemorrhage, and hyperensive and... View Article

A 67 years old man presents with rapid onset of right-sided weakness and a subjective feeling of decreased sensation on his right side. His family reported that he seemed to have difficulty forming sentences. Symptoms were maximal within a minute and began to spontaneously abate 5 minutes later. On arrival, 30 minutes after onset, his clinical deficits had largely resolved with the exception of a subtle weakness of his right hand. His history is significant for hypertension, diabetes, hyperlipidemia, and a 50 pack-year smoking habit. What is the most likely diagnosis?

December 26, 2020 8:17 am Published by

Transient ischemic attack

A 68 years old woman presents with 2-year decline in cognitive function. Her symptoms began with behavioural changes and progressed to short-term memory loss, tremor in her left arm, ataxia, and shuffling gait. Her family has noted some confusion, cognitive decline, and blunted affect. Physical exam and laboratory analysis are unremarkable. What potential sequelae do you need to be concerned about?

December 26, 2020 8:16 am Published by

Aspiration pneumonitis, deep vein thrombosis, pulmonary embolism and death

A 68 years old woman presents with 2-year decline in cognitive function. Her symptoms began with behavioural changes and progressed to short-term memory loss, tremor in her left arm, ataxia, and shuffling gait. Her family has noted some confusion, cognitive decline, and blunted affect. Physical exam and laboratory analysis are unremarkable. What are the most important differential diagnoses?

December 26, 2020 8:14 am Published by

Of the relevant differential diagnoses, it is important to rule out brain tumor, cerebrovascular insufficiency, and substance abuse (intoxication or... View Article

A 45 years old presents with sudden onset severe headache, unlike anything she had ever experienced. She vomited many times before seeking medical attention. On presentation she requires stimulation to maintain alertness and has mild nuchal rigidity. Examination reveals hypertension and slight ptosis and dilation of the left eye with minimal reaction to light. What potential sequelae do you need to be concerned about?

December 26, 2020 8:12 am Published by

Stroke, aneurysm, seizures and death

A 45 years old presents with sudden onset severe headache, unlike anything she had ever experienced. She vomited many times before seeking medical attention. On presentation she requires stimulation to maintain alertness and has mild nuchal rigidity. Examination reveals hypertension and slight ptosis and dilation of the left eye with minimal reaction to light. What are the most important differential diagnoses?

December 26, 2020 8:12 am Published by

Of the relevant differential diagnoses, it is important to rule out subarachnoid hemorrhage.

A 53 years old black woman presents with a sudden, excruciating headache that began while sitting at her desk at work. The headache is diffuse, intense, and accompanied by nausea and vomiting. She describes the headache as the worst headache of her life. She is a smoker and her history is significant for hypertension. On examination her level of consciousness appears slightly impaired, with slow reaction time to questions, and she has third cranial nerve palsies. There are no sensory deficits or weaknesses. Fundoscopic exam reveals bilateral retinal hemorrhages. What potential sequelae do you need to be concerned about?

December 26, 2020 8:09 am Published by

Ocular hemorrhage, hydrocephalus, cardiac abnormalities, neurogenic pulmonary edema, seizure and death

A 53 years old black woman presents with a sudden, excruciating headache that began while sitting at her desk at work. The headache is diffuse, intense, and accompanied by nausea and vomiting. She describes the headache as the worst headache of her life. She is a smoker and her history is significant for hypertension. On examination her level of consciousness appears slightly impaired, with slow reaction time to questions, and she has third cranial nerve palsies. There are no sensory deficits or weaknesses. Fundoscopic exam reveals bilateral retinal hemorrhages. What are the most important differential diagnoses?

December 26, 2020 8:08 am Published by

Of the relevant differential diagnoses, it is important to rule out sentinel hemorrhage, intracranial aneurysms, venous sinus thrombosis, arterial dissection... View Article