Concussion with abnormal MRI
Time and rest while symptoms continue. Topamax for his continued headache.
7 weeks after the initial injury, he still had symptoms with light activity. Continued symptoms included headache, blurry vision, emotional lability, and strange decorticate convulsive movements. Unable to progress on return to play protocol due to recurrent
headaches. He is being followed by neurology. Workup, imaging, recovery beyond 7 weeks is unknown.
There has not been any further follow-up available for this case.
This case is a good reminder of our differential diagnosis and management of brain injury in the acute setting.
I would be interested in the neurologist's thoughts on both the MRI findings as well as the nonepileptic convulsions. Are the MRI findings something that can be seen with trauma? or it this a slow growing tumor or other unidentified bright object? Are these prolonged convulsions a manifestation of conversion disorder? I would also be interested in how his rehabilitation is progressing over time.
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