USMLE® Step 1 style questions USMLE
A 65-year-old woman is brought to the physician by her partner due to recent behavioral changes. The symptoms began four months ago. According to the partner, the patient would be doing daily activities, such as chopping vegetables, and she would abruptly stop and appear to "blank out,” followed by resumption of the activity. Additionally, the patient recently got lost in the parking lot of a nearby grocery store that she has been visiting for many years. Past medical history is noncontributory. She does not smoke cigarettes or consume alcohol. Vital signs are within normal limits. Physical examination reveals rigidity in the bilateral upper and lower extremities. Tremors, which began two months ago, are present in both hands at rest. Which of the following is the most likely diagnosis?
An epidural hematoma is a collection of blood above the dura matter, usually due to a head trauma. When blood accumulates in this space, it can result in raised intracranial pressure, damaging delicate nerve cells.
Epidural hematomas are most commonly caused by head injuries, such as those sustained in car accidents or falls. They can also be associated with childbirth (in newborns), cancer, or certain medical procedures. Symptoms vary depending on the size and location of the hematoma, but may include a headache, nausea and vomiting, loss of consciousness, seizures, or paralysis.