07-27-2006, 02:31 PM
A 71-year-old man has been in excellent health, and practicing
competently as an attorney. He is brought to the emergency room
following a motor vehicle accident. A workup, including imaging of
the spine, thorax, and head, is negative, but the patient is admitted
for overnight observation. His injuries include several lacerations to
the face and extremities as well as several contusions to the thorax.
Three weeks later, he is admitted to the hospital for confusion.
A neurologic exam is normal except that he is not oriented to time
or place, and can recall only 1 out of 6 objects after 3 minutes.
Which of the following is the most likely diagnosis?
A. Alzheimer's disease
B. Brain metastases
C. Epidural hematoma
D. Normal pressure hydrocephalus
E. Subdural hematoma
competently as an attorney. He is brought to the emergency room
following a motor vehicle accident. A workup, including imaging of
the spine, thorax, and head, is negative, but the patient is admitted
for overnight observation. His injuries include several lacerations to
the face and extremities as well as several contusions to the thorax.
Three weeks later, he is admitted to the hospital for confusion.
A neurologic exam is normal except that he is not oriented to time
or place, and can recall only 1 out of 6 objects after 3 minutes.
Which of the following is the most likely diagnosis?
A. Alzheimer's disease
B. Brain metastases
C. Epidural hematoma
D. Normal pressure hydrocephalus
E. Subdural hematoma