Examining the Sensory System
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Normal Cerebrospinal Fluid The photos shown here is that of normal cerebrospinal fluid after a lumbar puncture. Normal cerebrospinal fluid is colourless and odorless. Xanthochromia The cerebrospinal fluid here shows xanthochromia (Figure 1), meaning of yellow discolorization. Presence of xanthrochromia means that there is presence of red cells in the cerebrospinal fluid. With time, the red…
This is a set of cranial MRIs from a patient with osmotic demyelination syndrome, formerly called central pontine myelinolysis. Osmotic demyelination syndrome occurs when wide fluxes in serum sodium levels are induced by too rapid correction of hyponatremia. Oligodendrocytes, which forms the myelin sheaths, are particularly vulnerable to osmotic changes. If the osmotic stress is…
A lumbar puncture (LP, also known as a spinal tap) is a diagnostic and at times, therapeutic medical procedure. Diagnostic indications The main diagnostic indications of performing a LP is for collection and evaluation of cerebrospinal fluid (CSF) for diagnosis and exclusion of infectious, inflammatory and neoplastic diseases affecting the central nervous system. For example,…
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…
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 cranial MRI (coronal cuts) shown here are from a patient presenting with fever and confusion. Multiple, ring-enhancing nodular lesions are noted in the FLAIR sequence (Figures 1 and 2) as well as in the T1W imaging with contrast (Figures 3 and 4). Serology was positive for toxoplasma and the patient was tested…