Submitted by: Submitted by exel
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Category: Science and Technology
Date Submitted: 10/06/2015 11:06 AM
Clinical Case Study
Nervous System
History of Present Illness: Gene Matson, a 75 year old male, was brought to the hospital
by his son following the acute onset of left-sided numbness and weakness that began one
hour prior to admission. His son stated that two weeks prior to admission Gene had a
single, 12-hour episode of garbled speech and left-sided face and arm weakness. Following
the first episode the right carotid angiogram pictured below was performed.
Past Medical History:
History of moderate hypertension treated with calcium channel blockers. History of
hypercholesterolemia. Mr. Matson smoked one pack of cigarettes per day for forty years, and drank
approximately four beers per day for several years.
Physical exam: Temperature: 37°C. Pulse: 72. Respirations: 12. BP 170/100
Neurological exam: Showed left‐sided hemiplegia (paralysis on one side) and hemianesthesia
(numbness on one side).
QUESTIONS
Answer the questions below to demonstrate your knowledge.
1. What are the pertinent aspects of the patient's past
medical history that are risk factors for his current
medical problem?
2. Damage to which lobe(s) accounts for the patient's
sensory and motor deficits?
3. Give an anatomical explanation for why damage to the
right side of the brain may cause sensory and motor
problems on the contralateral (opposite) side of the body.
4. Is there a surgical procedure that might have prevented
the current episode? If so, what is the procedure called?
5. Relate the findings in the angiogram to the patient's past
and present neurological problems in terms of:
a. how the vascular lesion could lead to neurological
problems.
b. what specific blood vessel in the brain must have been
affected by the process in "a" to account for his
symptoms.
6. What abnormality does the angiogram show? Describe the
lesion and the vessels in which it is located?