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Washington University Experience | VASCULAR | Small Vessel Disease | 3A0 Case 3 History
Case 3 History ---- The patient was a 79 year old man with history of hypertension, osteoarthritis of the right knee, prostate adenocarcinoma, and lupus anticoagulant who underwent a right total knee arthroplasty on 9/27 under general anesthesia with minimal blood loss. One day postoperatively, he had mental status changes and left sided weakness and was hypotensive with a systolic blood pressure in the 80s. Head CT was thought to represent possible normal pressure hydrocephalus. He was last seen alive that night at 11PM while receiving intravenous fluids but was discovered one hour later without pulse, apneic and unconscious. He could not be resuscitated. ---- At autopsy the weight of the unfixed brain was 1450g. There was patchy discoloration of the white matter. The lateral ventricles show substantial dilatation and blunting of the angles, particularly in the frontal and parietal lobes without significant cortical atrophy.
