An 85-year-old man presents with a sudden onset of severe occipital headache and has vomited on two occasions since the headache began. He also complains of double vision. He has a history of hypeension. His examination findings are : – Glasgow Coma Scale 15/15 – Mild neck stiffness noted – Power 5/5 in both upper and lower limbs. Where is the likely site of pathology?
Correct Answer: Posterior communicating aery
Description: -Double vision and vomiting implies features of Raised ICP & HTN -Mild neck stiffness indicates probability of SAH -Presence of ptosis ,since in the question eye is pulled laterally and down it means there is unopposed 6th nerve as the 3rd nerve is damaged. If Berry aneurysm ruptures into ACA : no cranial nerve palsy SAH w.r.t 3rd nerve palsy : PCA involvement HTN can lead to Charcot Bouchard Aneurysm can rupture-3rd nerve palsy Diagnosis: HTN with 3rd nerve palsy SAH : vascular malformation ruptured m/c nerve involved in ruptured/unruptured berry aneurysm is 3rd nerve as it runs adjacent to PCA
Category:
Medicine
Get More
Subject Mock Tests
Practice with over 200,000 questions from various medical subjects and improve your knowledge.
Attempt a mock test nowMock Exam
Take an exam with 100 random questions selected from all subjects to test your knowledge.
Coming SoonGet More
Subject Mock Tests
Try practicing mock tests with over 200,000 questions from various medical subjects.
Attempt a mock test now