Jas (Jazz)

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90 appearances 1 recordings 1 series first heard Jul 2026 last heard 31 Jul

Jas (Jazz)’s voice in public audio — every appearance, attributed to the second.

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Recordings per month over the last 12 months — 1 in all, peaking in Jul 2026 with 1.

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The Clinical Problem Solvers · Episode 469: SLS – Altered Mental Status · 31 Jul 2026 podcast

Now, there's also, unfortunately, some persistent focal abnormalities that are continuing to linger on, which tells me that there is a sustained structural injury that we still need to explain.

The language examination, to me, suggests a dominant frontal lobe syndrome.

Her speech is effortful, but is limited to short phrases consistent with a non-fluent aphasia.

The preserved reputation raises the possibility of a transcortical motor pattern rather than a classical Broca aphasia that we typically learn about.

And her inability to follow like a two-step command may reflect like residual encephalopathy, maybe an impaired working memory.

And the picture description finding, I think, is particularly helpful.

I think that is something that's probably the most localizing abnormality here.

And, you know, she can identify individual components but cannot integrate them into a coherent visual scene.

I think that really points towards the parietal-occipital relationship.

association cortex involvement here.

And in clinical context, it supports the extension of the lesion or lesions beyond the frontal language network into the dominant left parietal and occipital regions.

Her right-sided weakness and sensory loss further again, like localizes the lesion to the left hemisphere, possibly involving the corticospinal pathways and the left somatosensory cortex.

um i guess if i'm piecing this together um her examination localizes to a multifocal either multifocal or a very large cortical process involving the dominant left frontal parietal and the parietal occipital region so if i would if i were to bet i would say that the MRI likely has multiple lesions um and

You know, I guess the next question I would ask myself is why is a patient that has a very consistent presentation of a bacterial meningoid encephalitis that is having persistent unilateral cortical deficits?

And I would say my leading concern is a secondary cerebrovascular complication, particularly a meningitis-associated arterial vasculopathy with ischemic infarctions.

I've seen one case as a resident, and it was pretty catastrophic, actually.

And other conditions, I guess, can include a cerebral venous thrombosis, cerebritis, or an abscess.

I do find it a little bit hard to believe an abscess this significant was missed on the CT, but this is a patient I would definitely be getting a brain MRI with and without contrast to see if there's multiple lesions explaining our theory.

I think quickly commenting on the CSF studies because I think they're pretty critical.

Those are one of the worst CSF findings I've seen.

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