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Altered Mental Status and a Retro-auricular Mass

Published online by Cambridge University Press:  02 December 2014

Lauren M. Segal ,
Angela Walker ,
Eric Marmor ,
Errol Stern ,
Mark Levental ,
Rafael S. Glikstein  and
Hyman M. Schipper
Lauren M. Segal
Affiliation:
Sir Mortimer B. Davis Jewish General Hospital and Dept. of Neurology & Neurosurgery, McGill University, Montreal, QC, Canada
Angela Walker
Affiliation:
Sir Mortimer B. Davis Jewish General Hospital and Dept. of Emergency Medicine, McGill University, Montreal, QC, Canada
Eric Marmor
Affiliation:
Sir Mortimer B. Davis Jewish General Hospital and Dept. of Neurology & Neurosurgery, McGill University, Montreal, QC, Canada
Errol Stern
Affiliation:
Sir Mortimer B. Davis Jewish General Hospital and Dept. of Emergency Medicine, McGill University, Montreal, QC, Canada
Mark Levental
Affiliation:
Sir Mortimer B. Davis Jewish General Hospital and Dept. of Radiology, McGill University, Montreal, QC, Canada
Rafael S. Glikstein
Affiliation:
Sir Mortimer B. Davis Jewish General Hospital and Dept. of Radiology, McGill University, Montreal, QC, Canada
Hyman M. Schipper*
Affiliation:
Sir Mortimer B. Davis Jewish General Hospital and Dept. of Neurology & Neurosurgery, McGill University, Montreal, QC, Canada Sir Mortimer B. Davis Jewish General Hospital and Dept. of Medicine, McGill University, Montreal, QC, Canada
*
Lady Davis Institute, Sir Mortimer B. Davis Jewish General Hospital, 3755 Cote St. Catherine Road, Montreal, Quebec, H3T 1E2 Canada.
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A 29-year-old woman was found lying unconscious in the shower. There was a two-day history of headache and dizziness. In the emergency room, she was initially stuporous (Glasgow Coma Scale 10/15), afebrile, bradycardic and hypertensive. She exhibited roving, conjugate eye movements, left facial paresis (including frontalis), left ptosis, diffuse hypotonia, extensor plantar responses bilaterally and a 1.5 cm warm, fluctuant mass with surrounding erythema behind the left ear (Figure 1). Otoscopy revealed a bulge in the posterior wall of the left external auditory canal.

Type
Neuroimaging Highlight
Information
Canadian Journal of Neurological Sciences , Volume 33 , Issue 3 , August 2006 , pp. 317 - 319
Copyright
Copyright © The Canadian Journal of Neurological 2006

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