How to Think Like a Neurologist by Ethan Meltzer

Author:Ethan Meltzer [Meltzer, Ethan]
Language: eng
Format: epub, pdf
ISBN: 9780197576663
Publisher: OxfordUP
Published: 2022-09-15T00:00:00+00:00

Clinical course and additional information

He was seen in clinic approximately 1 month later. He endorsed persistent ataxia, vertigo, and nausea, but his symptoms concerning for elevated ICP (such as headaches that awoke him from sleep and hiccups) had fully resolved. A repeat MRI of his brain showed persistent edema, hemorrhage, and contrast enhancement. Now the neuroradiologists did not think a stroke was the likely cause, since there was no improvement on his MRI compared to a month prior. We would expect a stroke to change and resolve over time. What could this be? It isn’t a stroke because the pace of symptoms never fit, and the persistently abnormal MRI doesn’t fit. The biopsy didn’t show a tumor or other definitive pathologic diagnosis.

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