Article Type
Changed
Mon, 07/09/2018 - 10:50
Display Headline
Man with Decreasing Consciousness and Increasing Confusion

ANSWER
The radiograph demonstrates a lucency at the base of the odontoid (C2). In addition, there is a slight posterior subluxation of C1 on C2.

Although these findings were deemed likely to be chronic and old in nature, for completeness, an MRI of the cervical spine was obtained. It did, in fact, confirm the findings to be old.

Author and Disclosure Information

Nandan Hichkad, PA-C, MMSc

Issue
Clinician Reviews - 20(12)
Publications
Topics
Legacy Keywords
consciousness, nausea, vomiting, confusion, Cervical spine, no pain, lucency, base of the odontoid, odontoid (C2), posterior subluxation,
Sections
Author and Disclosure Information

Nandan Hichkad, PA-C, MMSc

Author and Disclosure Information

Nandan Hichkad, PA-C, MMSc

ANSWER
The radiograph demonstrates a lucency at the base of the odontoid (C2). In addition, there is a slight posterior subluxation of C1 on C2.

Although these findings were deemed likely to be chronic and old in nature, for completeness, an MRI of the cervical spine was obtained. It did, in fact, confirm the findings to be old.

ANSWER
The radiograph demonstrates a lucency at the base of the odontoid (C2). In addition, there is a slight posterior subluxation of C1 on C2.

Although these findings were deemed likely to be chronic and old in nature, for completeness, an MRI of the cervical spine was obtained. It did, in fact, confirm the findings to be old.

Issue
Clinician Reviews - 20(12)
Issue
Clinician Reviews - 20(12)
Publications
Publications
Topics
Article Type
Display Headline
Man with Decreasing Consciousness and Increasing Confusion
Display Headline
Man with Decreasing Consciousness and Increasing Confusion
Legacy Keywords
consciousness, nausea, vomiting, confusion, Cervical spine, no pain, lucency, base of the odontoid, odontoid (C2), posterior subluxation,
Legacy Keywords
consciousness, nausea, vomiting, confusion, Cervical spine, no pain, lucency, base of the odontoid, odontoid (C2), posterior subluxation,
Sections
Questionnaire Body

A 72-year-old nursing home resident is sent for evaluation of decreased level of consciousness, nausea, vomiting, and increasing confusion. He denies any recent injury or trauma. His medical history is significant for diabetes, stroke, dementia, atrial fibrillation, and hypertension. The patient denies any head or neck pain. His vital signs are stable. Overall, aside from reports of occasional confusion, his physical examination is benign. He moves all of his extremities well and appears to have no deficits, including no neck or back tenderness. In reviewing his lab work, you see his sodium concentration is 126 mEq/L. CT of the head shows only chronic changes. Cervical spine radiographs are also obtained; the lateral view is shown. What is your impression?
Article Source

PURLs Copyright

Inside the Article