title: A Man in His 40s With Headache, Lethargy, and Altered Mental Status.
abstract: A man in his 40s presented with 1 month of worsening confusion, fatigue, and headache. Results from laboratory analyses were notable for a complete white blood cell count of 17 000/μL (31% blast cells), a platelet count of 76 000/μL, and a hemoglobin level of 16.6 g/dL. Imaging studies revealed a large mixed-attenuation subdural collection in the right frontal region with prominent mass effect. The patient underwent an emergency neurosurgical procedure. The differential diagnosis, pathologic findings, and diagnosis are discussed.
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Boston2Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts3Department of Neurology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: McKee
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Boston2Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts3Department of Neurology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Etherton
authors.affiliation: Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Scott B
authors.initials: SB
authors.lastname: Lovitch
authors.affiliation: Department of Neurology, Massachusetts General Hospital, Boston2Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts3Department of Neurology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Anoopum S
authors.initials: AS
authors.lastname: Gupta
authors.affiliation: Dana Farber Cancer Institute, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Douglas S
authors.initials: DS
authors.lastname: Micalizzi
authors.affiliation: Department of Neurosurgery, Harvard Medical School, Boston, Massachusetts7Department of Neurosurgery, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Travis
authors.initials: T
authors.lastname: Tierney
authors.affiliation: Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts.
authors.forename: Martha
authors.initials: M
authors.lastname: Wadleigh
authors.affiliation: Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts3Department of Neurology, Harvard Medical School, Boston, Massachusetts.
authors.forename: Henrikas
authors.initials: H
authors.lastname: Vaitkevicus
mesh_terms: D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D003399:Craniotomy / Q000379:methods; D004253:DNA Nucleotidylexotransferase / Q000378:metabolism; D003907:Dexamethasone / Q000627:therapeutic use; D006261:Headache / Q000150:complications / Q000209:etiology* / Q000628:therapy; D006801:Humans; D053609:Lethargy / Q000150:complications / Q000209:etiology* / Q000628:therapy; D007938:Leukemia / Q000150:complications* / Q000175:diagnosis* / Q000628:therapy; D007963:Leukocytes, Mononuclear / Q000473:pathology; D000077287:Levetiracetam; D008279:Magnetic Resonance Imaging; D008297:Male; D001523:Mental Disorders / Q000150:complications / Q000209:etiology* / Q000628:therapy; D018697:Nootropic Agents / Q000627:therapeutic use; D010889:Piracetam / Q000031:analogs & derivatives / Q000627:therapeutic use; D014057:Tomography, X-Ray Computed
chemical_list: D018931:Antineoplastic Agents, Hormonal; D018697:Nootropic Agents; D000077287:Levetiracetam; D003907:Dexamethasone; D004253:DNA Nucleotidylexotransferase; D010889:Piracetam