Part 6: Traumatic Brain Injury: Rehabilitation Neurology

Question 2

Questions 1-3 Refer to the Following Case:

    A 45-year-old former bank executive presents to a neurologist after being discharged from a subacute inpatient facility 6 months after he received a severe closed head injury in a motor vehicle accident. He is able to ambulate independently but continues to have residual difficulties with functional use of his right hand, distractibility, disorganization, and poor longterm memory as well as irritability and anger outbursts. The patientís anger outbursts are occasionally violent and can seem unprovoked, but they tend to be triggered by episodes where others point out information that he was told but cannot remember.

    The patientís primary care physician is asked to fill out disability paperwork that includes documentation of evidence of the diagnosis. S he asks for the neurologistís input on explaining how the patientís magnetic resonance imaging (MRI ) findings, described simply as showing no focal strokes or contusions, may be related to the diagnosis of traumatic brain injury (TBI). W hen reviewing the patientís current MRI images, which of the following findings is most likely to be related to the diagnosis of TBI?
  •   Dark areas on gradient echo sequences in subcortical white matter
  •   Edema and swelling
  •   Linear T2 hyperintense white matter lesions that extend radially from the
    ventricles and are most apparent with contrast
  •   Multifocal cystic lesions in both hemispheres, most apparent on T2-weighted

Updated 12/03/2014 • jdw | Copyright ©2018 Turner White Communications