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Altered Mental Status and a Retro-auricular Mass

Published online by Cambridge University Press:  02 December 2014

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
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Extract

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
Copyright
Copyright © The Canadian Journal of Neurological 2006

References

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