Examining the Sensory System
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Multiple Sclerosis
The set of cranial MRIs shown here are from a young woman with a known history of relapsing-remitting multiple sclerosis. In the first scan (T2W axial cut), we can see multiple T2 hyperintense lesions involving bilateral cerebral cortices (Figure 1). These lesions are noted to be of a juxta-cortical and also peri-ventricular distribution, which are classical of multiple sclerosis. In the next…
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…
Basic anatomy of CT brain
a) Various Densities in Axial Brain CT The normal anatomy of brain is relatively easier to understand with CT than MRI, comparing to radiograph, it can better delineate different soft tissue density – Structures appearing “white” in an unenhanced CT brain can only be the following high density structures : 1. Bone e.g. cranium ( calcium-containing ) 2. Blood in acute bleeding ( later…
Ischaemic Strokes of Different Etiologies
There are a number of ways of classifying ischaemic stroke. One of them is by anatomical classification e.g. anterior versus posterior circulation, the precise artery involved (e.g. left middle cerebral artery infarction) or the structure affected (e.g. right pontine infarct). It can also be classified according to the underlying etiology. A commonly used classification system is the TOAST…
Encephalitis
A. Clinical manifestations The clinical manifestations of encephalitis may be similar to those of meningitis. However, altered level of consciousness is a predominant sign. It can range from mild lethargy to deep coma. Moreover, focal or generalized seizures occur in many patients with encephalitis, especially in severe disease. Virtually every possible type of focal neurological…
Muscle Wasting / Muscle Atrophy
One can appreciate from this photo that there is significant lower limb wasting (or muscle atrophy) of the right leg compared to the left. The right leg is also shorter compared to the left. Muscle wasting (or atrophy) is due to denervation of the muscle supplied by the motor nerve and occurs in lower motor…
