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Which of the following is the most likely cause of this patient's seizure disorder? A 40-year-old woman is brought to the emergency department 30 minutes after sustaining severe chest injuries in a motor vehicle collision. Despite appropriate treatment, she dies 1 hour later. She had a 25-year history of a well-controlled seizure disorder. A photograph of a coronal section of the brain obtained at autopsy is shown.





A. Glioblastoma multiforme
B. Herpes simplex encephalitis
C. Mesial temporal sclerosis
D. Neonatal ischemic stroke
E. Vascular malformation

This question is part of NBME 13 section 1 prt 2 of 2
Asked by Chachelly on Jan 16, 2018

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3 Answers

L. Bonadio

Its kind of my job to give answers

L. Bonadio
Teacher, MCA, PhD, Toledo

Answered on Mar 27, 2019

Mesial Temporal sclerosis is the most likely cause of this patient's seizure disorder. Mesial temporal sclerosis or MTS is the scarring of the medial or the middle of the temporal body lobes of the brain. The symptoms of medial temporal sclerosis are generally associated with focal epilepsy, such as seizures, muscle spasms or convulsions.

It can cause brain damage from traumatic injury, lack of oxygen to the brain, or uncontrolled seizures. Mesial temporal sclerosis is the erosion of neurons and scarring of the deepest part of the temporal lobe and is related to certain brain injuries.

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B. Rickets

B. Rickets

Answered on Mar 07, 2019

Correct answer is option E – Vascular malformation
Arteriovenous malformation (AVM) is rare and is usually diagnosed at the time of first seizure. It is an abnormal tangle of the blood vessels of the brain or spine.

Arteries shunt directly into the veins with no intervening capillary beds. As there is a fast flow of blood from arteries to veins, there is reduced flow of blood to the surrounding tissue and there is a reduced supply of oxygen and nutrient to these tissues. Seizures and headaches are the most common symptoms.

In the case of this woman, blood flow to the brain is lost, and the area with arteriovenous malformation will receive lesser oxygen and nutrients. That.]’s why the section of the brain shown in the brain appear necrotic.

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Chachelly

Chachelly

Answered on Jan 16, 2018

Vascular malformation
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