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Dr. Thanh Nguyen (Neurology): An 80-year-old man was admitted to the hospital in late summer because of difficulty walking, fatigue, confusion, and insomnia.
The patient had been in his usual state of health until approximately four weeks before admission, when he noticed severe fatigue, frequent yawning, and difficulty concentrating; insomnia, intermittent confusion, and unsteadiness of gait developed. During daily activities, he required multiple breaks that he had not needed previously.
Three weeks before admission, he saw his physician; the results of a physical examination and routine laboratory testing were normal. Computed tomographic (CT) scanning of the head and neck with
Differential Diagnosis
Clinical Diagnosis
Dr. Richard T. Johnson's Diagnosis
Pathological Discussion
Anatomical Diagnosis
Source Information
From the Department of Neurology, Microbiology, and Neuroscience, Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore (R.T.J.); the Departments of Radiology (R.G.G.) and Pathology (M.P.F.), Massachusetts General Hospital, Boston; and the Departments of Radiology (R.G.G.) and Pathology (M.P.F.), Harvard Medical School, Boston.
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