8/18/2019 Case Study Tumor Board Mar 2015 3

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Case Study

56 y/o M retired Staf Sargeant reerred to clinic

or dizziness, being of balance, and acial drooping

let side. Patient seen at Hardin MemorialHospital on eb !5 or abo"e symptoms o 5 days

duration. C# scan perormed at Hardin Memorial

Hospital $as normal.

He $as seen by PCP on Marc% !nd. He $as &&' ( ).

Cranial ner"es assessed as normal. He %as a

medical %istory o "ertigo and a surgical %istory o

%ernia repair. Patient %ad been prescribed

meclizine pre"iously but t%is did not %elp %is

dizziness. He denied any %istory o trauma or

in*ury.

+aug%ter reports t%at patient %e is acting unny.

He stops at green lig%ts and goes on red lig%ts.

Patient is a p%otograp%er and is putting pictures int%e rames incorrectly. Patient also reports t%at %e

eels tired and sleeps a lot.

M- completed at -reland &rmy Community

Hospital on Marc% )rd. -mpression is as ollo$s

&bnormal signal c%ange arising eit%er rom

anterior rig%t t%alamus or genu o t%e internalcapsule $it%out mass efect. #%is abnormal lesion

and signal e(tension demonstrates acute

restriction. #%e diferential diagnosis includes

glioma, CS lymp%oma, demyelinating disease or

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acute lacunar inarct. eurology consultation

re0uested or urt%er e"aluation and management.