Shaken baby syndrome Quiz: Ace Your Exams
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A 70-year-old man is brought to the emergency department for evaluation of headache, nausea, and vomiting for the past 24 hours. His partner states he has been more irritable and has had trouble remembering to do routine errands. Two weeks ago, the patient fell while skiing but did not seek medical evaluation. Past medical history is significant for coronary artery disease and hypertension. Current medications include atenolol, enalapril, furosemide, atorvastatin, and aspirin. The patient has smoked a pack of cigarettes daily for 40 years. Temperature is 37°C (98.6°F), pulse is 99/min, respirations are 16/min, and blood pressure is 160/90 mm Hg. The patient is ill-appearing. He is oriented to person, but not to place or time. During the examination, the patient is unable to answer questions or follow commands. Deep tendon reflexes are 4+ on the right and 2+ on the left. Babinski sign is present on the right. There is 4/5 weakness of the right hip flexors. The patient’s non-contrast head CT is demonstrated below.

Reproduced from Radiopedia
Disruption of which of the following structures is the most likely cause of this patient’s symptoms?

Reproduced from Radiopedia
Disruption of which of the following structures is the most likely cause of this patient’s symptoms?
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