Mr XYZ is a 53 yearz male. he is business man by profession.
he was brought to the emergency department by his family menberz for sudden loss consciousness after an episode of vomitting.
Mr XYz is a known case of type 2 diabetes mellitus. but he is not taking any medications. he was in usual state of health till taking his dinner. just after taking his dinner the patient had an episode of progectile vomitting. it was of small volume containing food. after that he lost consciousness.
his past history ravealed stroke which was 3 yearz back.
on examination
BP 170/90.
HR 90beats/min.
unconscious male who is dyspneac.
neurologic exam
unconscious.
b/l upper limbs reflexes were of grade 1 (hporeflexia)
b/l lower limbs reflexes were of grade 3 (hyperreflexia)
tone upperlimbs was hypo.
tone of lower limb was hyper.
corneal reflex were absent both sides.
primitive reflexes were absent.
dolls eye were absent.
signs of meningeal irritation absent.
labs
BSR was of 170mg/dl
what you suspect.
where is the lession.