Other changes on CT which are suggestive of an early ischaemic stroke include: loss of grey-white matter differentiation 
, cortical sulcal effacement 
, loss of the insular cortex 
(“insular ribbon” sign) and decreased density of the basal ganglia 
(“disappearing basal ganglia” sign) (Figures 1 and 2). These signs could be appreciated if the abnormal left side was compared to the right hand side.
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…
The gait is wide-based and the patient requires assistance from the physician for stabilization. The patient cannot turn within one or two steps but requires multiple steps. The physician then asks the patient to perform tandem-walking at the end of the video but the patient is unable to do so due to severe instability. The…
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…
The set of MRIs shown here are from a middle-aged woman with neuromyelitis optica (NMO) – an autoimmune astrocytopathy. She was diagnosed with left sided optic neuritis 18 months ago, at that time presenting with subacute onset of left eye visual loss, as well as pain upon eye movement. There were no other neurological symptoms…
This is a non-contrast cranial CT from a patient who sustained a fall injury, landing on the back of the head. The CT here shows the cranium utilizing the “bone window”. One can appreciate that the details of the skull bone is shown in greater detail. In contrast, the contents within the skull as well…
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…