Differential Diagnoses

Acute Anemia
Acute Subdural Hematoma Management in the ED
Anxiety Disorders
Benign Positional Vertigo in Emergency Medicine
Brain Neoplasms
Carbon Monoxide Toxicity
Chronic Anemia
Emergent Management of Subarachnoid Hemorrhage
Encephalitis
Herpes Simplex Encephalitis
Herpes Simplex Virus (HSV) in Emergency Medicine
Labyrinthitis
Mastoiditis
Meniere Disease (Idiopathic Endolymphatic Hydrops)
Meningitis
Migraine Headache
Multiple Sclerosis
Pediatrics, Meningitis and Encephalitis
Phencyclidine Toxicity
Stroke, Hemorrhagic
Stroke, Ischemic
Thrombolytic Therapy
Vertebrobasilar Atherothrombotic Disease
Vestibular Neuritis
Wernicke Encephalopathy

Workup

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Media Gallery

CT scan of a patient with an acute spontaneous cerebellar hemorrhage. The hemorrhage in the right lobe of the cerebellum is partly obscured by bony artifact.
MRI of a patient with an acute cerebellar hemorrhage less than 24 hours after presentation. MRI allows better resolution than CT scan without bony artifact. MRI is preferred over CT scan for imaging lesions in the posterior fossa.
CT scan of a patient with a large acoustic neuroma on the right side of the brainstem. The scan was performed after injection of intravenous contrast, which is critical for identifying tumors with CT imaging.
A CT slice through the brain of a patient with an acoustic neuroma. This slice reveals a level of the brain higher than the acoustic neuroma. The dilated third and lateral ventricles provide gross evidence of obstructive hydrocephalus due to pressure exerted by the tumor on the brainstem. A ventriculostomy, seen as a white circle in the right lateral ventricle, has been placed in an attempt to drain cerebrospinal fluid and relieve the excessive pressure above the brainstem.

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Author

Keith A Marill, MD, MS Faculty, Department of Emergency Medicine, Massachusetts General Hospital; Associate Professor, Harvard Medical School

Keith A Marill, MD, MS is a member of the following medical societies: American Academy of Emergency Medicine, Society for Academic Emergency Medicine

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: InCarda Therapeutics<br/>Received ownership interest from General Electric and Medtronic for none. for: Equity ownership: GE Healthcare; Medtronic; Gilead; Cytodyn; Amgen; Pfizer.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

J Stephen Huff, MD, FACEP Professor of Emergency Medicine and Neurology, Department of Emergency Medicine, University of Virginia School of Medicine

J Stephen Huff, MD, FACEP is a member of the following medical societies: American Academy of Neurology, American College of Emergency Physicians, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.

Chief Editor

Barry E Brenner, MD, PhD, FACEP Program Director, Emergency Medicine, Einstein Medical Center Montgomery

Barry E Brenner, MD, PhD, FACEP is a member of the following medical societies: Alpha Omega Alpha, American Academy of Emergency Medicine, American College of Chest Physicians, American College of Emergency Physicians, American College of Physicians, American Heart Association, American Thoracic Society, New York Academy of Medicine, New York Academy of Sciences, Society for Academic Emergency Medicine

Disclosure: Nothing to disclose.