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P.Bhavani.pptx

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Anilkumar Reddy

A 34-year-old female patient presented with a one-month history of clear, odorless, colorless watery discharge from the left nostril that increased with bending forward or sneezing. She also reported intermittent headaches and fever. Five years ago she experienced trauma from a slip and fall that caused her to hit her head on a wall. Her neurological examination was normal except for a 2.4mm defect found in her left cribriform plate, leading to a diagnosis of CSF rhinorrhea.

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Name- P. Bhavani Age- 34/F Mrd no- 1317613 Diagnosis – CSF Rhinorrhoea (2.4mm defect in left cribriform plate)
A 34/F patient who is right handed by nature , -c/o watery discharge from left nostril for 1 month, clear, odourless, colourless, more on bending forward, sneezing -c/o headache on and off , fever on and off. -h/o trauma due to slip and fall and hit wall 5 years ago. - No vomitings, seizures.
O/E:patient conscious, Vitals stable GCS-E4V5M6 -CNS examination Higher mental function • normal
CRANIAL NERVE EXAMINATION • CN 1: B/L sense of smell normal • CN2: VA – bilateral 6/12 fundoscopy –normal disc CN 3,4,6- • EOM- both normal • No nystagmus • No ptosis • Pupils- B/L 3mm equal and reactive.
CN 5- intact CN 7- intact CN 8 • B/L AC>BC webers not lateralised CN 9, 10 • Uvula midline • Palatal movements normal ,no asymmetry • Gag reflex intact
CN 11 • Shoulder shrugging – Normal on both sides CN 12 • No fasiculations of tongue • no Tongue deviation
Sensory system-normal Cerebellar signs: absent Tandem Gait : normal Meningeal signs: no
MOTOR SYSTEM: Tone • Normal in both upper and lower limbs Bulk • Normal in both upper and lower limbs
Power - right left Upper limb Shoulder- 5/5 5/5 Elbow- 5/5 5/5 Wrist- 5/5 5/5 Lower limb Hip- 5/5 5/5 Knee- 5/5 5/5 Ankle- 5/5 5/5 EHL- 5/5 5/5 -Hand grip - 100% 100% • Reflexes – • Superficial reflexes-present • DTR: BJ TJ S KJ AJ Right - 2+ 2+ 2+ 2+ 2+ Left - 2+ 2+ 2+ 2+ 2+ Plantars- both flexors
P.Bhavani.pptx
P.Bhavani.pptx
P.Bhavani.pptx

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P.Bhavani.pptx

  • 1. Name- P. Bhavani Age- 34/F Mrd no- 1317613 Diagnosis – CSF Rhinorrhoea (2.4mm defect in left cribriform plate)
  • 2. A 34/F patient who is right handed by nature , -c/o watery discharge from left nostril for 1 month, clear, odourless, colourless, more on bending forward, sneezing -c/o headache on and off , fever on and off. -h/o trauma due to slip and fall and hit wall 5 years ago. - No vomitings, seizures.
  • 3. O/E:patient conscious, Vitals stable GCS-E4V5M6 -CNS examination Higher mental function • normal
  • 4. CRANIAL NERVE EXAMINATION • CN 1: B/L sense of smell normal • CN2: VA – bilateral 6/12 fundoscopy –normal disc CN 3,4,6- • EOM- both normal • No nystagmus • No ptosis • Pupils- B/L 3mm equal and reactive.
  • 5. CN 5- intact CN 7- intact CN 8 • B/L AC>BC webers not lateralised CN 9, 10 • Uvula midline • Palatal movements normal ,no asymmetry • Gag reflex intact
  • 6. CN 11 • Shoulder shrugging – Normal on both sides CN 12 • No fasiculations of tongue • no Tongue deviation
  • 7. Sensory system-normal Cerebellar signs: absent Tandem Gait : normal Meningeal signs: no
  • 8. MOTOR SYSTEM: Tone • Normal in both upper and lower limbs Bulk • Normal in both upper and lower limbs
  • 9. Power - right left Upper limb Shoulder- 5/5 5/5 Elbow- 5/5 5/5 Wrist- 5/5 5/5 Lower limb Hip- 5/5 5/5 Knee- 5/5 5/5 Ankle- 5/5 5/5 EHL- 5/5 5/5 -Hand grip - 100% 100% • Reflexes – • Superficial reflexes-present • DTR: BJ TJ S KJ AJ Right - 2+ 2+ 2+ 2+ 2+ Left - 2+ 2+ 2+ 2+ 2+ Plantars- both flexors