Examining the Sensory System
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This is the non-contrast CT (Figure 1) of a patient with an acute right-sided epidural haematoma . The skull vault is a tight space and the haematoma is causing significant mass effect, resulting in mid-line shift (the right cerebral hemisphere is shifted to the left as it can be seen crossing the mid-line). The epidural space is a potential…
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,…
These are the cranial CT scans from a patient with a recent left cerebellar infarct . Due to the significant cytotoxic oedema as a result of the cerebellar infarct, the fourth ventricle is being compressed , thus obstructing the normal CSF flow. The CT scan shows features of obstructive hydrocephalus and there is dilatation of the third ventricle (now…
A. Clinical manifestations The clinical manifestations of suppurative intracranial thrombophlebitis depend on the sinus involved, the involvement of anatomical structures within the sinus, and coexisting central nervous system infection. The onset of symptoms may be abrupt or gradual depending on the extent and location of infection. Cavernous sinus: fever (>90%), periorbital oedema (73%), change in…
There are a number of causes of spontaneous parenchymal haemorrhages. These include: hypertension, vascular malformations and aneurysms, neoplasm (primary or metastatic), cerebral amyloid angiopathy, use of antiplatelet agents or anti-coagulants, blood dyscrasias and drug abuse (e.g. amphetamine and cocaine use). Parenchymal haemorrhages could also be subdivided into deep versus lobar haemorrhages, where deep haemorrhages (basal ganglia, thalamus,…
These two videos are from a middle-aged man presenting with progressive bilateral lower limb and right upper limb weakness for few months. In the first video, there are prominent fasciculations over the entire right upper limb. Whilst in the second video, fasciculations can also be noted over both lower limbs, but more prominent on the…