A 45-year-old white man was found unconscious on the floor of his rooming house flat. No other history was available.
At admission he was dirty and ill-shaven, and responded only to pain. Vital signs were pulse, 100 beats per minute and regular; respirations, 20/min and regular; temperature 38.3 C (101 F). Blood pressure was 220/120 mm Hg. He had purple ecchymoses over his left eye and a recent laceration behind the left ear. Cataracts obscured the fundi. The neck was supple, and the Battle sign was negative. Chest examination was normal except for diffuse inspiratory and expiratory rhonchi. One examiner heard a grade 2/6 systolic ejection murmur. The rest of the general physical examination was unremarkable.Neurological examination disclosed the following: His eyes were tonically deviated to the right but moved fully and conjugately to the left on the doll's head maneuver. The pupils were 3 mm