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 right basal ganglia and also a larger one at the left parietal lobe (Figures 2 and 3).
A middle-aged woman was admitted with drowsiness, weakness of all four limbs and visual impairment. Physical examination revealed that the patient had bilateral complete ophthalmoplegia, generalized weakness and spasticity,with brisk reflexes and bilateral upgoing plantar reflexes. A hyper-intense lesion at the level of the midbrain was noted on cerebral MRI (Figure 1). Cerebro-spinal fluid examination…
This is a non-contrast cranial CT from a middle-aged man with multiple cardiovascular risk factors who suffered a severe ischaemic stroke involving the left middle cerebral artery territory. There was significant cytotoxic cerebral oedema as a result of the extensive infarction. The patient was operated on by the Neurosurgeons and a left hemi-craniectomy was performed…
Vascular dementia is the second most common cause of dementia and accounts for approximately 10% of all dementias in developed countries. The incidence of vascular dementia increases with age and are associated with common cardiovascular risk factors (hypertension, diabetes, dyslipidaemia etc.). Patients often present with a sudden, stepwise, neurological deterioration and there may be other…
Creutzfeld-Jakob Disease (CJD) are prion diseases and can be subdivided into sporadic (account for 85% of cases), genetic (15% of cases) and acquired forms (<1% cases). CJD is rare with an incidence of 1-1.5 per million population per year with a peak age of onset of 55-75years. It is a common cause of rapidly progressive dementia. However, other symptoms including myoclonus, visual or…
A. Clinical manifestations Cranial subdural empyema: fever, headache, altered mental status, symptoms and signs of raised intra-cranial pressure, meningeal irritation or focal irritation. Spinal subdural empyema: back pain, radiculopathy and spinal cord compression. Cranial epidural abscess: fever and headache (can be quite asymptomatic), focal neurological signs and seizures, raised intra-cranial pressure. Spinal epidural abscess: back…
This cranial MRI is from a young woman who presented with low-grade fever, confusion, visual hallucinations and status epilepticus. Significant orofacial dyskinesias and autonomic dysfunction was also noted. Lumbar puncture was performed and cerebrospinal fluid (CSF) revealed mild lymphocytic predominant leukocytosis and slightly elevated protein. CSF glucose was within normal range and CSF for microbiological…