Division I Quarterback Flies To New Heights After Roughing The Passer Penalty

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Division I Quarterback Flies To New Heights After Roughing The Passer Penalty - Page #1

Author: Bahrom Firozgary, MD Co Author #1: Tu Dan Kathy Nguyen, MD Co Author #2: Vincent Mandola, MD Senior Editor: Kristine Karlson, MD, FAMSSM Editor: Sam Hwu, MD Patient Presentation: A 20-year-old male division I quarterback with no prior medical history presented with lethargy, headache, nausea, and eventual emesis at halftime. History: The patient was tackled multiple times over an hour (twenty-four minutes of game time) and at one point, drew a roughing the passer penalty. He finished the half and stood up, walked off the field under his own power into the locker room. Over eight minutes at half-time, the patient took off his helmet and experienced a worsening headache with a witnessed episode of non-bloody emesis and abnormal gaze. He became increasingly lethargic until unresponsive and was emergently transported to a Level 1 Trauma Center via Life Flight. In the emergency room, he regained consciousness, endorsing mild headache and mild posterior neck pain while in a cervical collar without nausea or reported visual or sensory deficits. He did not recall specific details of hits and halftime symptoms during his interview in the emergency room. Physical Exam: Pertinent vitals: Pulse pressure 100s, Heart rate 50s General: initially somnolent, then arousable HEENT: Normocephalic, atraumatic without periorbital bruising. PERRLA, EOMI, no otorrhea, no rhinorrhea, no epistaxis, no tracheal deviation. Cardio: Bradycardic rate, regular rhythm Pulmonary: Irregular respirations, Clear lung sounds bilaterally MSK: Cervical spinous-process tenderness underneath cervical-collar in place Neuro: AAOx3; Glasgow coma scale 15/15, no focal motor or sensory deficits Click here to continue. Challenge yourself by writing down a broad differential diagnosis before moving to the next slide.		Back
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