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An arterial wall The ventricular endothelium The pia arachnoid The dura mater The perivenular space 54. Within a day of admission, the right-sided weakness began to abate and within a week it completely resolved. On the fourth day of hospitalization, the patient abruptly lost consciousness and exhibited clonic movements starting on his right side and generalizing to his left side. The movements stopped within 3 min, but he had residual right-sided weakness for 24 h. The CT scan was unchanged from that obtained on admission.

30. The answer is e. ) Meningiomas occur with increased frequency in type 2 neurofibromatosis, a dominantly inherited disorder arising with a deletion on the long arm of chromosome 22. Women with breast cancer and other gynecologic cancers are also at increased risk of developing meningiomas, perhaps because of sex-steroid receptors on these tumors that enhance their growth when gynecologic disturbances occur. Estrogen or progesterone antagonists may be useful in the management of these tumors, but tamoxifen, an estrogen inhibitor, paradoxically stimulates the growth of meningioma cells.

The vestibular organ exposed to warm water sends impulses to the brainstem that indicate that the head is moving to the side that is being warmed. The eyes deviate to the opposite side to maintain fixation on their targets, but the eye movement actually breaks fixation. A reflex nystagmus toward the ear that is being stimulated develops as the brain tries to establish refixation, and the vestibular signals repeatedly prompt deviation of the eyes contralateral to the warm stimulus. 17. The answer is e.

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