LAUSR

Clinical introduction An 88-year-old woman presented with acute onset of involuntary limb movements for one day. Two days prior she had fallen a suffered a left hip contusion but no head trauma. There was no fever or difficulty breathing. Her heart rate was 72 bpm with blood pressure of 109/68 mm Hg. Physical examination revealed restricted left hip motion due to pain and a sustained twisted posture of the upper extremity without paresis. Glasgow Coma Scale was 15, and there was no evidence of Kernig’s or Brudzinski’s sign. She underwent a hip X-ray and non-contrast CT scan (figures 1 and 2). Figure 1 Anteroposterior X-radiograph of the hip. Figure 2 A non-contrast brain CT. Question What is the most likely cause of the clinical presentation? Acute meningitis Cerebral fat embolism Haemorrhagic stroke Hypertensive encephalopathy For answer see page 2 For question see page 1