2. Early Clinical Course

  • admitted to a local hospital when he developed expressive aphasia
  • CT scan showed a right temporal lobe mass with subfalcine
    and uncal herniation - lumbar puncture was NOT done
  • empirically started on acyclovir, ceftriaxone, flagyl, phenytoin, and
  • on the following day, MRI showed a large T2 hyperintense lesion
    in the right temporal lobe which was interpreted as tumor (glioma)
    and less likely as an infectious or ischemic process
  • transferred to Yale-New Haven Hospital for surgical evaluation
  • only phenytoin and decadron were continued after admission

No Significant Past Medical History

Social History

  • married with a child
  • no HIV risk behaviors
  • no tobacco or drug abuse
  • occasional ethanol

Breakpoint #2

  • Is there any additional history you would like to know about?