He Didn't See It Coming: An Unusual Concussion Complication

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He Didn't See It Coming: An Unusual Concussion Complication - Page #3

Lab Studies: He had normal x-rays of his cervical and thoracic spines. He had a normal CT of his head and cervical spine. He had a normal MRI of his brain on the day of injury and a normal MRI of his brain on day twenty-five following the injury when his symptoms worsened. Case Photo #1 Case Photo #2 Consultations: Neuropsychology was consulted upon the initial evaluation on day two following the injury. His ImPACT testing on day thirteen following the injury showed 83rd percentile in his verbal memory composite, 63rd percentile in his visual memory composite, 98th percentile in his visual motor speed, and 92nd percentile in his reaction time. His initial symptom score was 48, twenty-one days later it was 2. This score increased to 74 when his symptoms worsened on day twenty-five following his injury. They initially recommended that he rest and have gradual return to activity as he tolerates under the supervision of an athletic trainer. However, when his symptoms worsened on day twenty-five, they recommended complete rest including no school. Ophthamology was also consulted for his diplopia, blurred vision and photophobia. His vision testing was OD: 20/200 and OS: 20/300. His confrontational fields showed left vertical strabismus with distance and near testing. This was worse with right gaze and left head tilt. His visual field testing showed left homonymous hemianopia. They advised to patch one eye to limit blurred vision and to avoid further trauma. They expected him to improve in three to four months. Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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