A elderly female presented with history of progressive right-sided weakness and speech difficulty. She gives a history of a fall in her bathroom two months back. The most likely clinical diagnosis is :
Answer is D (Left chronic subdural haematoma) : Progressively increasing right sided focal neurological signs over a period of one month along with papilloedema suggest a diagnosis of an IntraCranial Space Occurring Lesion. (ICSOL). Given the history of head trauma in an elderly female chronic subdural haematoma is the diagnosis of choice. Chronic subdural haematoma : Chronic subdural haematoma is the common in conditions of cerebral atrophy notably old age and alcoholism. Minor trauma leads to a little insignificant bleeding in subdural space that goes unnoticed. As the blood breaks down over the next few weeks or months, fluids is drawn into subdural space because the breakdown products are hyperosmolol and membrane forms. This collection gradually enlarges and compress the brain producing focal neurological defecits mimicking tumor.
Progressive supranuclear palsy
Left cerebral tumor
Left sided stroke
Left chronic subdural haematoma