A neurosurgical patient admitted for investigation of severe headache is making no attempts to speak. The patient is watching you, his eyes focus on someone else as they enter the room and he looks over at the window as it is shut, but he is does not converse.
Which of the follow can cause this?
- A. ruptured basillar artery aneurysm
- B. vasospasm complicating ruptured basillar artery aneurysm
- C. posterior communicating artery vasospasm
- D. vasospasm following ruptured anterior communicating artery aneurysm
This patient has mutism. They are alert, but are making no attempt to speak. There are multiple causes, including thalamic stroke, but this "classically" occurs from lesions affecting the medial aspect of both frontal lobes - vasospasm post Subarachnoid Haemorrhage from a ruptured acomm aneurysm.