Posts Categorized: Neuro

Aftermath of a motor vehicle accident

This 45-year-old male presents with lower back pain due to a motor vehicle accident. Have a look at images 1 through 7, and see how many findings catch your eye.   Bone marrow edema within the L3 and L4 vertebral bodies nearly encompasses the entire L3 vertebral body and the majority of the L4 vertebral… Read more »

A close look at a transspatial thoracic spine abscess

This 55-year-old male patient has history of quadriplegia due to transsection of the upper cervical spinal cord (image 1, orange arrow). Within the last six months, the patient noticed an absence of muscle spasms from the lower lumbar and lower extremities. At the level of the T11-T12 intervertebral disc space, large loculated fluid collection /… Read more »

Watch out for other diagnoses that look similar in this pediatric brain case

This 10-year-old male has a history of encephalitis. Q1 – The most likely diagnosis is: (a) Herpes encephalitis (b) Adrenoleukodystrophy (c) Acute disseminated encephalomyelitis (d) Acyl-CoA oxidase deficiency (e) Metachromatic leukodystrophy   A1 – (b) Adrenoleukodystrophy Adrenoleukodystrophy (ALD) is an X-linked disorder affecting young males due to the accumulation of very long chain fatty acids… Read more »

Anatomy Queen or King for a day

Here is your chance to be an anatomy king or queen for a day. We plan on dispersing these anatomic snippets of the brain in small groups so as not to overwhelm you, however, you will find complete descriptions at MRI Online. You are shown one T1 sagittal image of a 71-year-old male. Focus on the… Read more »

Don’t miss the salient finding in this brain case

A 55-year-old man presents with headache, neck pain and dizziness. See if you can answer the questions below by looking at images 1 through 3 before looking at the duplicate images with arrows (images 4 through 6). Q1 – What is the salient finding on the presented MRI study? (a) Cortical atrophy (b) Dural venous thrombosis… Read more »

Do you know why this patient has resting tremor and diplopia?

Imaging signs on MR can be a helpful tipoff toward the correct diagnosis. Take a look at this textbook example in today’s neurological imaging case. This 71-year-old male presents with resting tremor and diplopia. Is the most likely diagnosis Parkinson’s disease, Lewy body dementia, Progressive supranuclear palsy, Alzheimer’s disease, or Frontobasal degeneration? Have a look… Read more »

What surgical emergency is afflicting this patient?

This 57-year-old female presents with hippocampal atrophy, sudden cognitive decline, and visual disturbances. Q1 – Using images 1 and 2, what is the most likely diagnosis? (a) Thrombosed aneurysm (b) Pituitary apoplexy (c) Craniopharyngioma (d) Choristoma   A1 – (b) Pituitary apoplexy   Q2 – Which statement is false about pituitary apoplexy? (a) Often requires urgent… Read more »

How should you attack this hemifacial spasm case?

This 41-year-old female presents with left hemifacial droop and spasm. Try to give the following questions a shot. Q1 – The differential diagnosis for causes of hemifacial spasm includes: (a) Meningioma (b) AICA vascular compression (c) Multiple sclerosis (d) PICA compression (e) All of the above Q2 – Other accepted neurovascular compression syndromes include all of the… Read more »

What sign is a can’t-miss in this case?

Case: A 64-year-old male presents with a three-year history of progressive back pain, lower limb weakness and unstable gait. He experiences no bowel or bladder difficulty and there is no history of prior trauma or spinal surgery. Physical examination revealed lower limb weakness with spasticity.   Findings: A focal dorsal indentation of the thoracic spinal… Read more »

Is there a bird in my head?

This 16-year-old male presents with a head injury. Denies neck pain, chest pain, abdominal pain or extremity pain. States that he did lose consciousness. Focus on the elongated right styloid process in image 1, and the elongated left styloid process of image 2. What do you think the diagnosis could be?   If you came up… Read more »