How would you manage this patient’s neurologic impairment?

A 28-year-old female presents to the emergency department with an occipital headache and neck pain. She mentions her symptoms appeared after hyperextending her neck while playing tennis the day before. Examination reveals dysdiadochokinesia and decreased lateral vision. A contrast head and neck CT demonstrate the findings seen here. Based on this patient’s probable diagnosis, which of the following treatments is most appropriate?

A. Surgical consultation
B. COX-2 inhibitor
C. Observation
D. Antithrombotic therapy

Find the answer, discuss this case, and more on Figure 1.

Explore cases, quiz yourself, and solve medical mysteries along with thousands of other medical professionals around the world on Figure 1, the free app where doctors expand their clinical knowledge.

Christy Crisologo

    Christy Crisologo is SDN’s Editor-in-Chief. She earned her BA in Communications from Asbury University and lives in Texas with her husband (and primary connection to the medical world) and their two young children. 

    Christy Crisologo has 148 posts and counting. See all posts by Christy Crisologo

    One thought on “How would you manage this patient’s neurologic impairment?

    • Surgical Consultation. Possible fracture of the cervical bone resulting in occlusion of one of the arteries (vertebral?), hence requiring surgical replacement of the bone. Lack of blood flow to cerebellum and occipital lobe could possible explain the loss in vision and dysdiadokinesia.

      Reply

    Discussion