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A 35-year-old woman was admitted to the emergency department because of difficulty walking, headache, and nausea.
Two weeks before admission, the patient had noticed that her gait had become increasingly unbalanced, so that she described herself as walking "like a drunk person." Bifrontal and occipital headache and neck pain developed over the next several days. These symptoms worsened, and nausea developed when she bent forward to put on her shoes. She did not experience dizziness or vomiting. Over the next week, her balance deteriorated and on one occasion she fell in the shower. Other people noticed that she tended to
Differential Diagnosis
Pathological Discussion
Discussion of Management
Anatomical Diagnosis
Source Information
From the Departments of Neurology (T.T.B.), Radiology (B.R.B.), and Pathology (N.L.H.), Massachusetts General Hospital and Harvard Medical School.
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