Resposes
1.A 75-year-old man is involved in a motor vehicle accident and strikes his forehead on
the windshield. He complains of neck pain and severe burning in his shoulders and
arms. His physical examination reveals weakness of his upper extremities. What type of
spinal cord injury does this patient have?
A anterior cord syndrome
B central cord syndrome
C Brown-Séquard syndrome
D complete cord transection
E cauda equina syndrome
ANS: B correct answersCentral Cord Syndrome
the central cord syndrome involves loss of motor function that is more severe in the
upper extremities than in the lower extremities, and is more severe in the hands. There
is typically hyperesthesia over the shoulders and arms. Anterior cord syndrome
presents with paraplegia or quadriplegia, loss of lateral spinothalamic function with
preservation of posterior column function. Brown-Séquard syndrome consists of
weakness and loss of posterior column function on one side of the body distal to the
lesion with contralateral loss of lateral spinothalamic function one to two levels below
the lesion. Complete cord transection would affect motor and sensory function distal to
the lesion. Cauda equina syndrome typically presents as low back pain with
radiculopathy.
A 37-year-old man fell from a ladder as he finished hanging the Christmas lights on his
house. The right side of his head hit the alley cement, and he lost consciousness for
about 1 minute; he woke up with a headache, but he had no other complaints. A few
hours later, the patient is brought to the emergency room by his neighbor because of an
intense headache, confusion, and left hand hemiparesis. On examination, the patient
has a bruise located over the right temporal region, mydriasis, and right deviation of the
right eye, papilledema, and left extensor plantar response. An emergency CT scan of
the head without contrast reveals a lens-shaped hyper-density under the right temporal
bone with mass effect and edema. What is the most likely diagnosis?
Answer Choices
1 Epidural hematoma
2 Subdural hematoma
3 Subarachnoid hemorrhage
4 Intracerebral parenchymal hemorrhage
5 Acute meningitis
ANS: 1 correct answersEpidural Hematoma
Epidural hematoma most often results from a traumatic tear of the middle meningeal
artery. Although a lucid interval ranging from minutes to hours followed by altered
mental status and focal deficits is typical for epidural hematoma, this clinical picture is
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