Question

question 15 (mandatory) (1 point) a 27 - year - old male patient presents to your office after a high - speed motor vehicle accident. he complains of severe headaches, nausea, vomiting, and photophobia. lab results reveal increased csf pressure, decreased csf glucose, and increased csf protein. which of the following is the most likely diagnosis? a) space occupying lesion b) encephalitis c) migraine heahache d) cervicogenic headache e) subarachnoid hemorrhage

Explanation:

• Space - occupying lesion: Usually causes increased intracranial pressure (ICP) like headache, nausea, vomiting. But CSF glucose is typically normal in non - infective space - occupying lesions.
• Encephalitis: Inflammation of the brain. Symptoms include headache, fever, altered mental status. CSF shows increased pressure, increased protein, and normal or slightly decreased glucose (in viral encephalitis, glucose is often normal; in some bacterial - like infections, it may be decreased).
• Migraine headache: Usually has normal CSF findings. Symptoms are headache (often unilateral, throbbing), nausea, vomiting, photophobia. But no changes in CSF pressure, glucose, or protein.
• Cervicogenic headache: Headache arising from neck structures. CSF is normal.
• Subarachnoid hemorrhage (SAH): Caused by trauma (high - speed motor vehicle accident in this case). Symptoms: severe headache (often "worst headache of my life"), nausea, vomiting, photophobia. CSF in SAH: initially may have blood (not mentioned here, but other CSF changes - increased pressure (due to blood and possible obstruction of CSF pathways), decreased glucose (in some cases, due to blood breakdown products affecting glucose metabolism in CSF), increased protein (due to blood and inflammation)).

Answer:

e) Subarachnoid hemorrhage