Part IV – The Results
John had spent most of the past two days sitting in the semi-private room, either talking with his wife or waiting for her to return from one test or another. He had seen their daughter that morning as he snatched a quick breakfast between taking a shower and coming to the hospital.
“Laura’s just fine. She’s got my parents wrapped around her finger,” John said to his wife as they waited for the doctor.
Lynn looked at the door as the doctor entered the room; John quickly stood up.
“Good morning, Dr. Samson.”
“Good morning. How are you feeling this morning, Lynn?”
“I feel a little better, but the stabbing pains are keeping me awake at night. Did you find out what the problem is?”
“I have the results from the cerebrospinal fluid test we did.”
“You mean the fluid they took with the spinal tap needle? I will remember that needle until the day I die; I didn’t know they made them that long.”
| Cerebrospinal fluid test results | |
|---|---|
| IgG antibodies | Not elevated; within normal limits |
| Oligoclonal bands | Not elevated; within normal limits |
| Myelin breakdown | No evidence |
The doctor walked to the light box on the wall and pushed in x-rays into the lightbox.
“Is everything okay?” asked John as he looked over the doctor’s shoulder.
Figure 2. Arteriorgram of Lynn’s head very soon after a tracer dye was injected into her right carotid artery.*
Questions
Lynn’s cerebrospinal fluid showed normal levels of IgG antibodies and oligoclonal bands, and no myelin breakdown. What do these findings indicate?
What does Lynn’s x-ray show?
Lynn’s blood pressure was 160/98. From what type of blood vessel is blood pressure measured; artery, capillary, vein?
The values given for blood pressure represent the systolic and diastolic pressures, but what does blood pressure really mean? Is it the pressure along the inside of the vessel, across the vessel wall, outside the vessel?
What correlation is there between Lynn’s high blood pressure and what you see in her x-ray?
What procedures do you think Dr. Samson will suggest to alleviate Lynn’s high blood pressure, the problem shown in the x-ray, and the pain she is experiencing in her face?
With the above signs and symptoms in mind, do you wish to speculate about Lynn’s condition?
*Image used with the permission of Mercy Health Partners, Toledo, Ohio. Patient information has been altered in order to preserve the privacy of the original patient, with whose consent the image has been used.
Originally published at http://www.sciencecases.org/face_pain/case4.asp
Copyright © 1999–2010 by the National Center for Case Study Teaching in Science. Please see our usage guidelines, which outline our policy concerning permissible reproduction of this work.
