Insufficient circulation in the vertebra-basilar system.
Mother of a 9-month old infant has consulted her physician due to recurrent vomiting which has developed a month ago. In the age of 6 months child has fallen off the 60-cm high sofa hitting his head; there was swelling of parietal region and repeated vomiting which lasted one day. One month after the injury cranial part of the head has started to enlarge and the great fontanel has enlarged. Upon examination child is hypotrophic, cranial part of the head is enlarged, skin is thin, transparent, veins on the skin of the head are dilated, the great fontanel is tense. Establish the preliminary diagnosis.
Child was born at term. Parturition was uncomplicated. In the frontal region along the midline there is a tumor-like swelling 4x4x5 cm. Over the
swelling skin is unchanged, and the swelling increasing when child is straining. No changes were detected in the neurologic status. Determine the type of pathology.
Patient has fallen down and hit his head; there was a short loss of
consciousness. In two hours pulsating noise has developed in his right side of the head, hyperemia of the right eye conjunctiva , right-side exophthalmus which is increasing and weakness in the left extremities. What caused this clinical presentation?
A 34-year old patient is complaining of constant pain in the interscapular region, predominantly on the left side, which increases in the recumbent position and during abrupt movements. During coughing pain becomes darting and spreads to the left subscapular region. Pain increases during percussion of the spinal process of Th5. A month ago patient developed weakness in his lower extremities, numbness of his feet and shins. Sensitivity disorders have an ascending pattern. Which is the most possible diagnosis?
A 32-year old patient has fainted when lifting heavy loads and fell down. Upon admission his status is severe. According to his relatives' words -
until this event he has been practically healthy and had no complaints. No traumatic lesions are detected on the cranium. Focal neurologic symptoms are absent. During lumbar puncture CSF is intensely colored with blood, CSF pressure is 200 mm FkO. What is the most likely cause of the disease;
A 28-year old patient has been hospitalized in a severe status and unconscious. Patient is pale, her pulse is threadlike and frequent, blood pressure 60/0 mm Hg. Focal neurologic symptoms and meningeal signs are absent. In the frontal region there is an abrasion and a small hemorrhage. Emergency team physician has said that patient had been found unconscious.
A 62-year old patient is in severe status. Patient reports severe headaches which increase in the morning, vomiting, and limited movements in the left extremities. Patient has been sick for 2 weeks and his status is progressively deteriorating. Patient has been smoking since he was 20 years old. For the last year patient has been reporting constant coughing. Patient is skinny, skin is grayish and dry; signs of intoxication. There are focal symptoms of right hemispheric lesion; on the fundus - edema of the optic nerve disks. What is the preliminary diagnosis?
Patient is reporting headache which is more prominent on the right side, fever up to 38°C, and weakness in the left extremities. From the history it is known that 2 months ago patient has been discharged from the hospital where he has undergone a surgery due to open impressed comminuted of the right parietal bone. During examination there is a 4x4 cm defect of the right parietal bone. Skin over the defect is moderately painful and hyperemic. Anisocoria; tendon reflexes are predominant on the left side, muscle strength is somewhat decreased in the left extremities, hemihypaesthesia on the left side. An 8 mm leftward dislocation of midline echo has been detected. What preliminary diagnosis is most likely?
Chronic subdural hematoma;
A 30-year old patient has been admitted to the neurosurgical department in a severe status. Profound torporous disorder of consciousness, moderate anisocoria (D>S), hemiparesis and hemihypaesthesia on the left side. From the history it is clear that patient has chronic otitis . Two weeks ago he has undergone a surgery due to right-side otitis media. One week after the surgery patient's status has deteriorated, he has developed headache and fever up to 38°. During Echo-EG - an 8 mm leftward dislocation of midline echo is detected.