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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 338:180-188 January 15, 1998 Number 3
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Case 2-1998— A 50-Year-Old Woman with Increasing Headache and a Left Abducent-Nerve Palsy
Daniel H. O'Leary, and Suzanne de la Monte

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Presentation of Case

A 50-year-old right-handed woman was admitted to the hospital with worsening headache and a left abducent-nerve palsy.

The patient had been well until six weeks earlier, when she began to have diffuse headaches that fluctuated in intensity, became increasingly severe, and were soon accompanied by neck pain and stiffness. Changing her position for sleeping and taking nonsteroidal antiinflammatory drugs and oxycodone–acetaminophen provided no relief.

Ten days before admission, the patient noticed blurred vision on looking ahead or to the right and horizontal diplopia on looking to the left. She could read only when looking downward. Magnetic resonance imaging (MRI) of . . . [Full Text of this Article]

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Dr. Daniel H. O'Leary's Diagnosis

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