Clinical Vignette A 66-year-old woman experienced the near immediate onset of a terrible temporal pain that radiated into her forehead. She almost lost consciousness. She became nauseated, vomited, and felt disoriented. Her family called emergency medical services, who brought her…
Clinical Vignette A 40-year-old right-handed man with a past medical history significant for hypertension presented to the emergency department (ED) via ambulance with sudden-onset right hemiparesis. He did not take antithrombotic medications. His initial blood pressure was 184/93 mm Hg. The…
Coma Clinical Vignette A 57-year-old man with coronary artery disease develops severe chest pain and heaviness on exertion, then loses consciousness while working in the garden with his wife. Emergency Medical Services is called immediately and arrives at the scene…
Clinical Vignette A 62-year-old man with hypertension and diabetes mellitus type 2 was brought to the emergency department via Emergency Medical Services for evaluation of acute onset of obtundation. Over the course of approximately 1 minute, he changed from being…
Cranial Nerve XI: the Spinal Accessory Nerve Cranial nerve (CN) XI, or the spinal accessory nerve (SAN), serves primarily as the motor nerve for the sternocleidomastoid (SCM) and trapezius muscles in the neck and shoulder. It has an intriguing functional…
Clinical Vignette A 62-year-old judge became aware of subtle weakness of his left lower face that he first noted while shaving. Two months later, he noted that he could no longer close his left eyelid fully and was having increasing…