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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)
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…
This is a patient with neurofibromatosis type 1, an autosomal dominant neuro-cutaneous disorder. In the first two photos (Figures 1 and 2), multiple neurofibromasas well as café-au-lait spots are present on the trunk and upper limbs. In the third and forth photo (Figures 3 and 4), freckling can be seen at the axillary and inguinal…
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…
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…
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