Expansion of Thalamic Hemorrhage After Initial Presentation


Intracerebral hemorrhage (ICH) accounts for 20-35% of all strokes. Hypertension is the commonest underlying cause of ICH. The common sites for hypertensive ICH are putamen, thalamus, pons, cerebellum, subcortical and lobar hematomas. Basal ganglia (putamen) is the most common site for ICH accounting for about 50% of all cases. Thalamus holds the second position andContinue reading “Expansion of Thalamic Hemorrhage After Initial Presentation”

FASCICULATIONS


Amyotrophic lateral sclerosis (ALS) is a degenerative neurological disease affecting only the motor system. It is also referred to as motor neuron disease (MND) and is characterized by muscle wasting, weakness and fasciculations. Fasciculations refer to involuntary contractions/twitching of affected muscles. Affected muscles are wasted (thin) and weak. In this video, you can see fasciculationsContinue reading “FASCICULATIONS”

Ptosis due to Extraocular Muscle Swelling


60-year old gentleman presented with 5-day history of left sided ptosis and proptosis. He had conjunctival congestion. He was a diabetic, however, he had no history of thyroid disease. MRI brain showed swelling of left superior rectus, levator palpebrae superioris and lateral rectus muscles on the left side. Differential diagnosis include: Thyroid eye disease, idiopathicContinue reading “Ptosis due to Extraocular Muscle Swelling”

Extensive Calcifications on Brain MRI in a case of Hypoparathyroidism


16-year old presented with seizures of five years duration. Seizures were of generalized tonic-clonic type. He was earlier diagnosed to have hypoparathyroidism on the basis of low serum calcium and low PTH levels in blood. MRI brain showed bilateral symmetrical calcifications involving caudate nucleus, globus pallidus, thalamus and dentate nucleus of cerebellum. Calcifications were hyperintenseContinue reading “Extensive Calcifications on Brain MRI in a case of Hypoparathyroidism”

Dysembryoplastic Neuroepithelial Tumor (DNET) causing Refractory Focal Seizures


Dysembryoplastic neuroepithelial tumor (DNET) is relatively uncommon benign tumor, responsible for causing partial seizures in children, many of those cases may be medically refractory. The most common location is temporal lobe, as in this case (about 65% of cases). About 20% cases involve frontal lobe. The remainder of cases involve caudate nucleus, cerebellum and pons.Continue reading “Dysembryoplastic Neuroepithelial Tumor (DNET) causing Refractory Focal Seizures”

Subependymal Calcification Demonstrated on SWI MRI in a Case of Tuberous Sclerosis


Tuberous sclerosis is a multi-systemic genetic disease, which predominantly manifests with seizures and cutaneous manifestations (such as adenoma sebaceum). Abnormalities on brain scan include cortical tubers, subependymal nodules (sually calcified) and subependymal giant cell astrocytoma (SEGA). MRI is usually preferred over CT scan as tubers and SEGAs are better appreciated on MRI as compared toContinue reading “Subependymal Calcification Demonstrated on SWI MRI in a Case of Tuberous Sclerosis”

Hyperdense MCA sign in Acute Ischemic Stroke


55-year old gentleman, known diabetic and hypertensive presented with symptoms of right hemiplegia and aphasia of three hours duration. He was evaluated for possible thrombolytic treatment. CT brain done (3.5 hours after stroke symptom onset) showed a dense (also referred to as hyperdense) MCA sign (yellow arrow in the 1st image). Thrombosis of middle cerebralContinue reading “Hyperdense MCA sign in Acute Ischemic Stroke”

CAVERNOMA Causing Chronic Focal Epilepsy


FLAIR MRI images shows a left frontal hypointense lesion with multiple flow voids, surrounded by hyperintense areas, suggestive of a cavernoma with surrounding gliosis. The patient had a history of right focal motor seizures (with or without secondary generalization) of 5 years duration, which was well controlled with medications (oxcarbazepine, sodium valproate and clobazam). Therefore,Continue reading “CAVERNOMA Causing Chronic Focal Epilepsy”

THE DENSE PCA SIGN-Posterior Cerebral Artery Visualised on CT Scan


Dense or hyperdense MCA (middle cerebral artery) sign is a well recognized sign of early ischemia and is associated with large infarctions in MCA territory. Dense PCA sign is not so well recognized, however, it can be seen in about 35% of all cases of PCA territory infarction. It is typically located in ambient cistern,Continue reading “THE DENSE PCA SIGN-Posterior Cerebral Artery Visualised on CT Scan”

Rapid Expansion of Hypertensive INTRACEREBRAL HEMATOMA


54-year old lady presented with left-sided hemiparesis and drowsiness of 6 hours duration. Her BP at admission was 220/160 mmHg. She was started on anti-hypertensive medications. After 11 hours, her clinical condition worsened and she became comatose. Anisocoria was also noted. BP was 160/100 mmHg. CT scan of brain was repeated, which showed massive increaseContinue reading “Rapid Expansion of Hypertensive INTRACEREBRAL HEMATOMA”