Drs Gary Lau, Henry Mak, Raymand Lee, Richard Chang, Windsor Mak, Gilberto Leung, Brian Kot, Edward Hui, Yat Fung Shea, Koon Ho Chan, Joseph Kwan, Jacky Lee and Anderson Tsang
The Parkinson-plus syndromes include 1) multi-system atrophy, 2) progressive supra-nuclear palsy and 3) corticobasal degeneration. Multi-system atrophy Multi-system atrophy (MSA) is a rare adult-onset sporadic neurodegenerative disorder. There are two main subtypes, as identified by its dominating symptomatology. MSA-P is when parkinsonian symptoms predominate, and MSA-C if cerebellar symptoms dominate. These two terms have replaced…
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…
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…
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…
Ischaemic stroke with haemorrhagic transformation, also known as haemorrhagic infarct, occurs in approximately one-third of cases of ischaemic stroke. Haemorrhagic infarct occurs more commonly in the elderly, those with larger infarcts as well as those having received thrombolytic therapy. The mechanism of haemorrhagic infarct has been postulated to be due to the breakdown of the basal…