Posts Categorized: Neuro

What has happened to this man’s spine?

This 44-year-old male presents with back and right leg pain. Take a look at the first two images without arrows before looking at the duplicate images with arrows. Q1 – The most likely diagnosis is: (a) Schwannoma (b) Meningioma (c) Epidural lipomatosis (d) Synovial cyst   A1 – (d) Synovial cyst   Synovial cysts are… 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 »

What is the cause of this patient’s weakness and ascending numbness?

This 48-year-old female has indicated lower extremity weakness and numbness. Using image 1, can you identify the abnormality?   Dural arteriovenous fistula (AVF), the most common spinal vascular malformation, is evident in image 2 (green arrows). There are just too many hypointense “dots”. Dural AVF account for 65% of all vascular malformations of the spine…. Read more »

Be sure to make the right differential considerations in this brain case

This 43-year-old female presents with neck pain. Try to work through the case looking at just the first four images, before looking at the same images with arrows indicating key findings. Q1 – The differential diagnosis includes all of the following, except: (a) Glomus (b) Meningioma (c) Epidermoid (d) Schwannoma   A1 – (c) Epidermoid… Read more »

Simple follow-up or important finding?

This 38-year-old male had a seizure 22 years ago. This is a follow-up scan, and the patient has no recent seizures or head trauma. See what you can discern from the first two images before looking at the duplicate images 3 and 4 (with highlighted area on image 4). Q1 – The finding represents: (a)… Read more »

Tinnitus and left facial droop and hearing loss (oh my)

This is a 57-year-old female with external ear vesicles, tinnitus, left facial droop and hearing loss. Have a look at the first two images without arrows, and see if you can answer the following questions. Afterwards, have a look at the duplicate images with arrows which highlight the key findings.   Q1 – The most… Read more »