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A 57-year-old right-handed man was admitted to the hospital because of the sudden onset of slurred speech and left hemiparesis.
The patient had been well until two days earlier, when he fell and fractured his left humerus. His daily aspirin was discontinued because of the fracture. He was last seen well by his mother-in-law at 2 p.m.; at 2:15 p.m., she noted that he was drooling, had slurred speech, and could not swallow pills. She called his wife, who came home from work immediately and found him unable to move his left arm or leg. He stated that he did
Differential Diagnosis and Medical Management
Surgical Management
Final Diagnosis
Source Information
From the Departments of Neurosurgery (B.S.C.), Radiology (J.D.R.), Pathology, Division of Neuropathology (R.P.), and Neurology (L.H.S.), Massachusetts General Hospital; and the Departments of Neurosurgery (B.S.C.), Radiology (J.D.R.), Pathology (R.P.), and Neurology (L.H.S.), Harvard Medical School.
Related Letters:
Case 5-2004: A Man with Slurred Speech and Left Hemiparesis
Ben-Hur T., Cohen J. E., Rabinstein A. A., Schwamm L. H., Carter Bob. S.
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N Engl J Med 2004;
350:2213-2214, May 20, 2004.
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