Sat27November0556PM 33

A 70-year-old woman presented with an acute, severe occipital headache, unsteadiness of her gait, and vomiting. She had a history of poorly controlled hypertension.

On examination there was nystagmus to the left, ataxia of the left limbs, and gait ataxia.

Which of the following is the most likely diagnosis?

(Please select 1 option)

Acute cerebellar haemorrhage Correct

Subdural haemorrhage

Temporal lobe haemorrhage

Basal ganglia haemorrhage

Pontine haemorrhage

Explanation

Cerebellar haemorrhage:

The most common symptoms are of severe nausea and vomiting, and ataxia. Headache may be severe. Patients with cerebellar haemorrhage can rapidly become comatose within hours after the onset from herniation, because of its limited space in the posterior fossa.

Pontine haemorrhage:

There are numerous nuclei located within the pons. Rapidly deteriorating level of consciousness, impaired extraocular movement, and extensive sensorimotor deficits are clinical clues to pontine haemorrhage.

Basal ganglia haemorrhage:

Contralateral hemiparesis, hemisensory loss, or hemi-inattention. Aphasia, especially non-fluency and impaired comprehension, is frequently seen if haemorrhage occurs in the posterior limb of the left internal capsule.

Answer Statistics

1

85%

2

2%

3

1%

4

8%

5

6%

Times answered: 287