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Abstract
Clinical introduction An 88-year-old woman presented with acute onset of involuntary limb movements for one day. Two days prior she had fallen a suffered a left hip contusion but no head trauma. There was no fever or difficulty breathing. Her heart rate was 72 bpm with blood pressure of 109/68 mm Hg. Physical examination revealed restricted left hip motion due to pain and a sustained twisted posture of the upper extremity without paresis. Glasgow Coma Scale was 15, and there was no evidence of Kernig’s or Brudzinski’s sign. She underwent a hip X-ray and non-contrast CT scan (figures 1 and 2).
Anteroposterior X-radiograph of the hip.
A non-contrast brain CT.
Question What is the most likely cause of the clinical presentation?
Acute meningitis
Cerebral fat embolism
Haemorrhagic stroke
Hypertensive encephalopathy
For answer see page 2
For question see page 1
- neurology
- imaging, CT/MRI
- accidental falls
- musculo-skeletal, fractures and dislocations
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Footnotes
Contributors T-HH managed the case and wrote the manuscript. J-TL analysed and reviewed radiological data and contributed to manuscript review. Y-DH is the corresponding author and performed critical revisions.
Competing interests None declared.
Patient consent Obtained.
Provenance and peer review Not commissioned; internally peer reviewed.
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