Neuroanatomy
Dr Raymond Chang
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Ischaemic Changes of Different Anatomical Regions or Vascular Territories
Bilateral watershed infarct The non-contrast CT brain shown is from a patient with bilateral watershed infarct. Here, chronic ischaemic changes can be seen along the external or cortical watershed zones (Figures 1 and 2). These “borderzones” is where the terminal vasculature of the anterior cerebral artery and middle cerebral artery meet as well as where the middle…
Assessing the Level of Consciousness
Dr Gilberto Leung and Dr Gary Lau Subtitles in English for this video can be displayed by clicking on (first button on the bottom right hand corner of the video). Our level of consciousness is governed by our cerebral cortex as well as the subcortical ascending reticular formation. Patients with normal consciousness have a high level…
Intention Tremor
As one can appreciate in this video, this middle-aged man has right-sided intention tremor. The right index finger shows exaggerated tremor when approaching the target, i.e. his nose and physician’s finger. Please note that the examiner should place his finger at around one arm’s length from the patient. This is so that the patient could…
Osmotic Demyelination Syndrome
This is a set of cranial MRIs from a patient with osmotic demyelination syndrome, formerly called central pontine myelinolysis. Osmotic demyelination syndrome occurs when wide fluxes in serum sodium levels are induced by too rapid correction of hyponatremia. Oligodendrocytes, which forms the myelin sheaths, are particularly vulnerable to osmotic changes. If the osmotic stress is…
Heel-shin Test
In this video, the patient exhibits a positive heel-shin test on the right side. Compared to the left (normal) side, the right lower limb is seen to be rather clumsy. The heel-shin test is a test to screen for ipsilateral cerebellar function. Once again, clear instructions are required for this test, and you could see…
Lower Limbs
Subtitles in English for this video can be displayed by clicking on (first button on the bottom right hand corner of the video). Inspection of the Lower Limbs After positioning the patient on the bed and ensuring adequate exposure, the lower limbs should be inspected as follow: The examiner should stand at the end of the bed and…