GIANT CISTERNA MAGNA


Giant cisterna magna, also called as mega cisterna magna, is a normal variation, and therefore, it is not a disease. It is found in about 1% of all scans done postnatally. The cisterna magna is the space between the inferior margin of the vermis and the posterior rim of the foramen magnum. The normal cisterna magna measures between 3 mmContinue reading “GIANT CISTERNA MAGNA”

Extensive Calcification in Brain in Fahr’s Disease


36-year old man presented with neuropsychiatric disturbances and developmental delay since childhood. There was no positive family history. Investigations for calcium and phosphorus metabolic disorders were normal. He had no evidence of hypoparathyroidism or pseudohypoparathyroidism. CT brain showed extensive symmetrical calcifications involving bilateral basal ganglia, corona radiata and subcortical regions. A diagnosis of idiopathic nonfamilialContinue reading “Extensive Calcification in Brain in Fahr’s Disease”

Alexia Without Agraphia in a Case of Stroke


50-year old gentleman presented with acute onset inability to read (alexia). However, he was able to write (he had no agraphia). On dictation, he could write on paper, however, he was not able to read what he had written. This clinical syndrome is called “alexia without agraphia” or pure alexia. MRI brain showed an acuteContinue reading “Alexia Without Agraphia in a Case of Stroke”

Anti-MDA-5 Antibody positive Dermatomyositis


Clinically amyopathic dermatomyositis (CADM) is a subset of dermatomyositis, where there is skin involvement without myositis. There is no or little muscle weakness and serum CPK levels are normal or mildly elevated. Patients with one of the variants of CADM present with ulcerated Gottron’s papules and rapidly progressive interstitial lung disease (RP-ILD). Anti-MDA5 (anti-melanoma differentiation-associatedContinue reading “Anti-MDA-5 Antibody positive Dermatomyositis”

POST-TRAUMATIC RIGHT FRONTAL CONTUSION


This is the CT scan of a 24-year old person man who met with a road-traffic accident. He was riding a two-wheeler, without wearing helmet. CT scan shows right frontal contusion, with mass effect. There is fracture of overlying frontal bone. Treatment is conservative in the initial stage with anti-cerebral edema measures and anti-epileptic drugs.Continue reading “POST-TRAUMATIC RIGHT FRONTAL CONTUSION”

Resting Tremors in Parkinson’s Disease


Parkinson’s disease is the commonest cause of tremors. In this disease, tremors occur at rest. In the accompanying video, you can see resting tremors in a woman, who has Parkinson’s disease of 6 years duration. The tremors are asymmetric, affecting the right upper limb more than the left upper limb.

Huntington’s Disease (HD)


This video shows a 55 year old woman with features of generalised involuntary movements, predominantly affecting facial muscles and upper limbs (distal > proximal). Involuntary movements consist of chorea and athetosis. Occasional facial tics are also seen. Her other clinical features were dementia and behavioural changes. There was a positive family history of similar illness.Continue reading “Huntington’s Disease (HD)”

Psychogenic Non-epileptic Seizures


Psychogenic non-epileptic seizures are common. These seizures are not due to epileptiform discharges in the brain and EEG recording during the seizure episodes are normal. On careful history taking, an underlying stress or psychiatric diagnosis can be found in most of these cases. These are also referred to as pseudo-seizures, hysterical seizures or dissociative (conversion)Continue reading “Psychogenic Non-epileptic Seizures”

Acute Hydrocephalus Developing After Pontine Hemorrhage


Pontine haemorrhages are uncommon and account for about 10% of all cases of intracerebral hemorrhage (ICH). Hypertension is the most common underlying cause, accounting for about 90% of all cases. Pontine hemorrhages are associated with high morbidity and mortality. About 40% people with pontine bleeds do not survive. Low GCS at admission and hemorrhage volumeContinue reading “Acute Hydrocephalus Developing After Pontine Hemorrhage”

MRI Lesions Mimicking Dawson’s Fingers in a Case of Small Vessel ischemia


Dawson’s fingers are periventricular lesions in patients with multiple sclerosis (MS). These are flame-shaped lesions or finger like projections, perpendicular to ventricles and represent perivenular inflammation surrounding medullary veins. Dawson’s fingers are typically seen in patients with multiple sclerosis. However, here, I present a case of small vessel ischemia, whose MRI showed lesions mimicking Dawson’sContinue reading “MRI Lesions Mimicking Dawson’s Fingers in a Case of Small Vessel ischemia”

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