Hsiao-Kan Liu, M.D., and Wen-Chau Chen, M.D. N Engl J Med 2011; 364:1761, May 5, 2011
A 48-year-old man who had sustained a traumatic fracture of the left femoral shaft in a motorcycle accident 20 hours earlier was referred for a deterioration of consciousness that began after the accident. He was unresponsive to verbal stimuli, and no focal neurologic abnormalities were found on examination. An arterial blood gas analysis revealed mild hypoxemia, but a radiograph of the chest was normal.
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