12-24-2007, 08:26 AM
A 40-year-old man has the sudden onset of
excruciating head and
neck pain while carrying books from the basement to
the attic. His
temperature is 37 C (98.6 F), blood pressure is 130/90
mm Hg, and pulse is
90/min. He has photophobia and develops eye pain with
lateral eye
movements. His neck is markedly stiff and cannot be
passively flexed. He
has diffuse hyperreflexia in all extremities with
normal strength and
sensation. Plantar reflexes are flexor bilaterally.
Which of the
following is the most likely diagnosis?
A
) Cervical osteoarthritis
B
) Meningitis
C
) Ruptured cervical disc
D
) Subarachnoid hemorrhage
E
) Syringomyelia
excruciating head and
neck pain while carrying books from the basement to
the attic. His
temperature is 37 C (98.6 F), blood pressure is 130/90
mm Hg, and pulse is
90/min. He has photophobia and develops eye pain with
lateral eye
movements. His neck is markedly stiff and cannot be
passively flexed. He
has diffuse hyperreflexia in all extremities with
normal strength and
sensation. Plantar reflexes are flexor bilaterally.
Which of the
following is the most likely diagnosis?
A
) Cervical osteoarthritis
B
) Meningitis
C
) Ruptured cervical disc
D
) Subarachnoid hemorrhage
E
) Syringomyelia