Case 16-1990

Presentation of Case A 57-year-old woman was admitted to the hospital because of headache, somnolence, increasing right hemiparesis, and a ring-enhancing lesion in the left thalamus. The patient was in a stable state of health until four days earlier, when she awoke with a left-sided headache, bilateral periorbital pain, and fatigue and returned to sleep for most of that day. Three days before admission she began to fall toward the right while walking, and her family noticed subtle problems with her speech; she remained somnolent. On the following day the right arm was weak. The patient was admitted to a . . .