1. C ASE S TUDIES IN N EUROPATHOLOGY Kenneth Clark, MD Neuropathology Fellow, UPMC

2. C LINICAL H ISTORY 30-year-old man with no significant past medical history. No smoking, no drug abuse, no meds 2-month history of “flu-like” symptoms Awoke in the morning and returned to bed stating “I don’t feel well” A couple of hours later his wife found him unresponsive in bed  medics

3. Clinical Course Arrived at the emergency department, intubated and unresponsive CT scan of the head revealed the following…

6. Differential Diagnosis

7. Clinical Course Labs drawn… Physical exam: –Pupils fixed and dilated –No pain response –No spontaneous respirations

8. Clinical Course Lab results –WBC > 600,000 –14% blasts –6% promyelocytes –22% myelocytes –5% metamyelocytes –22% bands –22% neutrophils –5% eosinophils

9. Differential Diagnosis

14. http://www.radiologyassistant.nl/en/48f4c4ccd9682 LENTICULOSTRIATE VESSELS

22. Cause of Death Acute Myelogenous Leukemia

23. M ECHANISM OF D EATH

25. H ERNIATION http://missinglink.ucsf.edu/lm/ids_104_cns_injury/Herniation/Herniation.htm