Posts Categorized: Brain

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 is this 34-year-old’s controversial brain diagnosis?

This 34-year-old male presents with occipital headaches. Q1 – Looking at image 1, what do you think the most likely diagnosis would be?   A1 – This patient has Chiari I malformation.   Q2 – Which of the following is true? Chiari I malformation features: (a) Male predominance (b) Symptoms likely markedly increased with greater than 5… Read more »

Why is this woman having left-sided weakness post Chiari decompression?

This 30-year-old female presents with left-sided weakness post Chiari decompression. Q1 – What is the most likely diagnosis? (a) Inadequate decompression (b) Hydrocephalus with slit ventricles (c) Pseudomeningocele (d) Cerebellar ptosis (e) Dandy-Walker continuum Try to answer the question by looking at the first five images. Then, have a look at the latter five (images… Read more »

Can you find the cause of this 29-year-old’s headaches?

This 29-year-old female presents with headache. Look at the first four images and try to determine the answer before looking at the latter four duplicate images with arrows. Q1 – What is the most likely diagnosis? (a) Alobar holoprosencephaly (b) Dandy Walker variant (c) Septo-optic dysplasia (d) Kallman syndrome   A1 – (c) Septo-optic dysplasia Q2… Read more »

Why is this 2-year-old behind in development?

This 24-month-old reports with developmental delay and drags her right leg. Look at the first four images without arrows, and see what you come up with for a diagnosis. Then, take a look at the next four duplicate images with arrows indicating key findings.   Q1 – The diagnosis of lissencephaly (type II) may be… Read more »