1) Mr. philips has been suffering with gradually worsening headaches which he is now unable to
control with pain relief. He states that the headaches are present when he wakes up in the
morning and worse if he is lying down.
• There is a midline shift and clear that the one ventricle is larger than the other.
• Most likely cause is a brain tumour which is most likely cause by glial cells which are the
most common cause of primary brain tumours. However primary brain tumours are rare.
Most of the time brain tumour are secondary e.g from breast or lung.
• Fairly uncommon in the UK with 15 per 100,000
• Affects the 50-70
• Patient may present with nausea, headache, vomiting, seizures, ataxic gait, weight loss
2) A 21 year old male becomes unwell one day whilst at lectures, he has a headache and a fever
and does not feel himself. He goes home to lie down, but when his flat mate checks on him
he seems confused and difficult to rouse.
• Concerns that he may have meningitis
• Should always keep an eye out for progression
• The meninges are affected which can cause raised intracranial pressure due to puss formation
or inflammation. Bacteria affect the CFS
• No blanching purpuric rash
• Antibiotics immediately
• Vasoconstriction in peripheries which can lead to amputation
• C1 & C2 innervate the meninges, hence why neck pain occurs
• AVPM is a measure of consciousness
Brown- sequard syndrome:
This is due to hemisection of the spinal cord, where by the spinothalamic and dorsal column
sensory pathways are affected. The patient will no longer be able to feel fine touch and vibrations
on the same side as the trauma due to the dorsal pathway being damaged and being ipsilateral.
Additionally they will no longer be able to feel pain or temperature on their opposite side below the
trauma due to the damage of the spinothalamic tract which is controlateral.
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