Case records of the Massachusetts General Hospital. Case 18-2011. A 35-year-old HIV-positive woman with headache and altered mental status.

摘要

Dr. Mikad Rinne (Neurology): A 35-year-old right-handed woman with human immunodeficiency virus (HIV) infection was admitted to this hospital because of headache and altered mental status after a motor vehicle accident.Earlier that day, while driving without a seatbelt, the patient was involved in a head-on collision at low speed. She did not lose consciousness but was noted by witnesses to behave strangely. On evaluation at another hospital, she was disoriented. There were no external signs of trauma, and the vital signs were normal. Results of routine laboratory studies were normal. Computed tomography of the head, without the administration of contrast material, revealed prominent areas of low attenuation in both hemispheres, without contusions or hemorrhage. Dexamethasone was administered intravenously, and the patient was transferred to this hospital.