Atypical Post-concussion Symptoms In A Young Adult Female Soccer Player

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Atypical Post-concussion Symptoms In A Young Adult Female Soccer Player - Page #1

Author: Seth Camhi, MD, MBA Co Author #1: Paul Brydon, DO Co Author #2: Kenneth S. Taylor, MD Patient Presentation: Patient is an 18 yo healthy F with no significant PMH who is a freshman soccer player at UCSD. She had just recently arrived to school and was at a soccer meeting prior to college physicals when she stood up and had an acute onset of umbilical abdominal pain that was associated with a sensation like she was going to have a bowel movement as well as nausea and a sense of vertigo. She then syncopized and fell backward on the concrete from a standing position hitting her head. She briefly lost consciousness and had woken up and was oriented by the time EMS arrived. When EMS questioned her, she was complaining of nausea, vomiting and reported that the room was spinning along with a severe headache. She was then taken to the hospital by Ambulance for evaluation. The only significant precipitating event uncovered after obtaining a detailed history of the events leading up was that she had chiropractic manipulation the day prior by her father who is a chiropractor. History: PMH - Negative PSH - Negative FH - None SH - (-) smoke, (-) EtOh, (-) IVDA. Meds - None Allergies - NKDA Physical Exam: Gen: AA&Ox3, NAD Vitals: T: 36.8 C, RR 14, HR 77, BP 125/48 HEENT: NCAT, eyes: PERRLA, EOMI. Initial eye exam in ED: +rotary nystagmus to the left on Left gaze. Ear: clear, TMI - no retraction or fluid. Nose: septum: mild Rt deviation, mucosa healthy, turbinates: healthy. Oropharynx: clear Neck: Supple, No LAD, no thyromegaly CV: S1S2, RRR, no murmur Resp: CTA bilaterally, no wheezing GI: Soft, non tender, non distended, (+) BS, no hepatosplenomegaly Ext: No deformities or edema, (+) peripheral pulses Neuro: CN I - no response to coffee or alcohol. CN II-XII - grossly intact. Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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