A Day in Neurology

A 90 year old Holocaust survivor with a history of a stroke was assaulted in an elevator, his wallet stolen. He was admitted to our service for an expressive aphasia. He could understand everything we said and follow complex commands, but he couldn't repeat or say anything. When shown a tie, he could not name it but if given a list, he could point at the correct word.

A man who suffered multiple brainstem strokes, now "locked in" so that he can only move his eyes.

An older Cantonese gentleman who is active, conversant, wandering around the hallways but does not understand that his cognition has been destroyed by neurosyphilis.

A Filipino woman who had rapidly progressing dementia with language problems, gait instability, and personality changes. She puzzled the service for months; we ran every test would could think of and yet couldn't diagnose her. In the end, we had to do a brain biopsy, which unfortunately showed primary central nervous system lymphoma.

A young African American woman who presented with a severe right brain stroke. Her left arm and leg are completely paralyzed. On further history, we found that her boyfriend had hit her in the jaw, causing a tear in her carotid artery which sent a clot to her brain. We contacted social work and the police because of domestic violence.

An older man who says he "suffered a massive stroke" and laments that he is "completely paralyzed on his left side." Meanwhile, he is seen eating with both hands, adjusting the TV with his left hand, and eventually sauntering down the hallway with the help of physical therapy. Yet all the while, he said he was completely paralyzed and could not be convinced otherwise. He is now in psychiatry.

An inmate from San Quentin, allegedly in for selling oxycodone, presents with transient changes in vision. He was handcuffed and shackled, accompanied by a police officer.

A woman with a massive bleed into the brain due to a ruptured aneurysm. Neurosurgery took her into the operating room at 8am to clip the aneurysm. She did not return to the intensive care unit until 5am the following day; it was a 21 hour surgery.