Even Amateur Athletes Can Have Drip

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Even Amateur Athletes Can Have Drip - Page #1

Author: Keith DellaGrotta, MD Co Author #1: Landon Mueller, MD Senior Editor: Heather Rainey, MD Editor: Irvin Sulapas, MD Patient Presentation: Healthy-appearing 29-year-old male with no relevant past medical history presented with persistent, severe headache after softball game injury. History: A 29-year-old otherwise healthy male presented to sports medicine clinic for evaluation of a head injury. Two weeks earlier, he sustained a blunt head injury while playing softball, where he collided with another player. He denied loss of consciousness but quickly developed a headache and two episodes of vomiting. A head CT was obtained at a local ER on the day of the injury, which was negative. At the time of his first clinic visit, the patient reported persistent headaches, difficulty focusing gaze, neck pain, and difficulty sleeping. He was started on amitriptyline for headaches and was referred for physical and vision therapy. At the two-month follow-up, he reported improvement in visual symptoms and cervicalgia, but his headaches were not better and were limiting his ability to return to work. The headaches improved when lying flat and consuming caffeine. Physical Exam: General: well appearing in no distress HEENT: normocephalic, atraumatic, extraocular movements intact, moist mucous membranes Heart: Normal rate Lungs: No labored breathing Abdomen: No distension Skin: No apparent rash Musculoskeletal: cervical paraspinal muscle tenderness bilaterally, no midline vertebral tenderness, full range of motion of spine and all four extremities without pain Neurologic: alert and oriented, cranial nerves II-XII intact, full strength and sensation in all four extremities No symptoms with vestibular-ocular motor screening Normal balance including Romberg, tandem, and single-leg stance Psychiatry: Normal mood and affect Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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