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Case Records of the Massachusetts General Hospital
Weekly Clinicopathological Exercises
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Volume 347:2057-2065 December 19, 2002 Number 25
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Case 39-2002 — A 35-Year-Old Man with Headache, Deviation of the Tongue, and Unusual Radiographic Abnormalities
William F.C. Rigby, Chieh-Min Fan, and Eugene J. Mark

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Presentation of Case

A 35-year-old right-handed man was admitted to the hospital because of a persistent headache and deviation of the tongue.

The patient had been in excellent health until about one month earlier, when a left-sided headache developed, with occasional bright spots in the left visual field, subjective fever, chilliness, and anorexia; he lost 5 kg of body weight at this time. The headache became severe and was not affected by nonsteroidal antiinflammatory agents, the patient's position, straining, or coughing. During this period, his tongue deviated to the left and caused drooling, although he had no dysphasia or dysphagia.

One week before . . . [Full Text of this Article]

Differential Diagnosis

Disorders of Cranial Nerve XII

Diseases Affecting the Aorta and Its Major Branches

Giant-Cell Arteritis

            Takayasu's Arteritis

            Temporal Arteritis

Clinical Diagnosis

Dr. William F.C. Rigby's Diagnosis

Discussion

Anatomical Diagnosis




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