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General Inspection
During the general inspection of the cranial nerves, we should look for whether the patient has any ptosis, abnormal eye movements and facial asymmetry. We should also inspect for whether there are any neuro-cutaneous features (for example in patients with tuberous sclerosis and neuro-fibromatosis), syndromal features etc.
Cranial Nerve I (Olfactory Nerve)
Cranial Nerve II (Optic Nerve)
Visual Acuity
Visual Fields
Inspection of the Pupils
Direct and Consensual Light Reflexes
The Swinging Torch Test
Accommodation Reflex
Cranial Nerves III (Oculomotor Nerve), IV (Trochlear Nerve) and VI (Abducens Nerve)
Cranial Nerve V (Trigeminal Nerve)
Cranial Nerve VII (Facial Nerve)
Cranial Nerve VIII (Vestibulocochlear Nerve)
Cranial Nerves IX (Glossopharyngeal Nerve) and X (Vagus Nerve)
The scans shown are from two immunocompromised patients who presented with high fever and recurrent seizures. The contrast cranial CT of the first patient shows that the patient had a rim-enhancing lesion at the left basal ganglia (Figure 1). A set of cranial MRIs of the second patient also showed multiple contrast enhancing lesions in the…
In this contrast thoracic CT scan of a middle-aged woman with newly diagnosed seropositive generalized myasthenia gravis, an abnormal thymic lesion (present in the anterior mediastinal compartment) could be seen (Figure 1). The patient was referred to the Cardiothoracic Surgeons where she received a thymectomy via an open sternotomy. The thymic specimen was sent for histo-pathological…
Dense middle cerebral artery sign There are a number of radiological features that can be seen in the non-contrast CT scan which support the clinical suspicion of an ischaemic stroke. One of the early ischaemic changes that could be recognized on a non-contrast CT film is the “dense middle cerebral artery (MCA) sign“. As you can…
a) Principles of CT scan Computed Tomography (CT) is an imaging modality that uses computer-generated analysis ( i.e. computed ) of the x-ray attenuation through a section of the body tissue to produce cross-sectional images ( i.e. tomography ) with great anatomical details. Unlike plain X-ray images which are projected images of one plane, CT…
The MRI images shown here (Figures 1 to 5) are from a patient with cerebral amyloid angiopathy (CAA). CAA is caused by the accumulation of aggregated amyloid-β (Aβ) plaques in the walls of small to medium-sized arteries and penetrating arterioles. Such aggregates are due to an imbalance between Aβ production and clearance. Whilst Aβ40 (40 meaning…
Frontotemporal dementia is the most common cause of dementia in patients under the age of 65. There are three different subtypes: 1) behavioural-variant frontotemporal dementia,the most common subtype which is characterised by changes in personality and social conduct; 2) progressive nonfluent aphasia – a disorder of language output that may occur in the absence of…
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