07-10-2008, 07:37 AM
A 67-year-old man comes to the emergency department because of sudden onset of severe vertigo, headache, nausea, vomiting, and inability to walk. He has a history of hypertension. On examination, his blood pressure is 190/110 mm Hg; pulse, 100/min, respiratory rate, 18/mm, and temperature, 36.7 C (98 F). He is in distress from severe headache and nausea. He has dysarthria, prominent nystagmus on lateral gaze, and clumsiness of the left arm on finger-to-nose maneuver, and he falls to the left when he tries to sit up.
Which of the following is the most likely cause of this patient™s presentation?
A. Menieres disease
B. Vestibular neuronitis
C. Cerebellar hemorrhage
D. Benign positional vertigo
Which of the following is the most likely cause of this patient™s presentation?
A. Menieres disease
B. Vestibular neuronitis
C. Cerebellar hemorrhage
D. Benign positional vertigo