07-10-2008, 04:16 AM
A 74-year-old man with a history of hypertension is brought to the emergency department after being found unresponsive by his wife in bed. He is intubated for airway protection. Blood pressure is 210/90 mm Hg; pulse, 80/min; and temperature, 37 C (98.6 F). When his eyes are opened by the examiner, there are intermittent spontaneous downward eye movements. There are no spontaneous horizontal eye movements, nor are there horizontal movements in response to the doll™s head maneuver. The pupils are very small but reactive. He does not move any extremities on command. There is occasional spontaneous extensor posturing in his arms and legs, and Babinski™s signs are present bilaterally. He blinks his eyes three times in a row on command.
Which of the following is the most likely cause of this patient™s condition?
A. Anoxic encephalopathy
B. Left middle cerebral artery stroke
C. Pontine infarct
D. Cerebellar infarct
Which of the following is the most likely cause of this patient™s condition?
A. Anoxic encephalopathy
B. Left middle cerebral artery stroke
C. Pontine infarct
D. Cerebellar infarct