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A 70-Year-Old Man Is Brought to the Emergency Department Due

question 594

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A 70-year-old man is brought to the emergency department due to left-sided weakness and slurred speech upon awakening 30 minutes ago.  The patient was asymptomatic when he went to bed last night.  Medical history includes type 2 diabetes mellitus, hypertension, and hyperlipidemia.  The patient is a former smoker with a 30-pack-year history.  Physical examination shows a right gaze preference, left lower facial droop, and hemiplegia and hemisensory loss on the left.  CT scan of the brain reveals early infarction in the right middle cerebral artery territory with no acute hemorrhage.  The patient is hospitalized for further management.  Several hours later, he becomes progressively obtunded with elevated intracranial pressure.  A repeat CT scan reveals edema in the region of acute infarction causing mass effect.  Which of the following is the primary contributor to the pathogenesis of this patient's raised intracranial pressure?


Definitions:

Return Flight

A flight heading back to the point of origin, typically part of a round-trip ticket.

Greyhound

A slender, fast-running dog breed known for racing and as a gentle, intelligent companion animal.

Overnight Bus

A transportation service that operates during nighttime hours, allowing passengers to travel long distances while sleeping.

Opportunity Cost

The value of the best alternative that must be foregone as a result of choosing another option.

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