Intra-cranial Haemorrhage due to Head Injury

Byepsuadmin August 21, 2014June 14, 2015

Often, as a consequence of severe head injury, there may be haemorrhage within various intracranial compartments. In these 2 cases (Patient 1 – Figure 1, Patient 2 – Figures 2 to 11), both patients sustained a severe head injury. A combination of subdural , parenchymal and subarachnoid haemorrhage could be seen. In the second case, there is also evidence of a chronic left subdural haematoma , which may be due to prior head injury. Figure 11 is the bone window of the non-contrast CT and shows a thin vertical crack at the occiput of the skull, representing a skull fracture as a result of the head injury .

Neuro-immunology

Bickerstaff’s Encephalitis

Byepsuadmin August 21, 2014June 16, 2015

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…

Intracranial Haemorrhage | Neuro-imaging | Vascular Disease

Subdural Haematomas

Byepsuadmin August 21, 2014June 14, 2015

Subdural haematomas are far more common than epidural haematomas and acute subdural haematomas are one of the leading causes of death and disability in patients with severe traumatic brain injury. Subdural haematomas are due to an accumulation of blood between the dura and arachnoid. This is most often due to head injury resulting in a…

Vascular Malformations

Arterio-venous Malformations

Byepsuadmin August 21, 2014June 14, 2015

Cerebral vascular malformations can be classified by histopathology into 4 major types: Arterio-venous malformations (AVMs) Venous angiomas (developmental venous anomalies) Capillary telangiectasias and Cavernous malformations Arterio-venous malformations (AVMs) are congenital vascular lesions due to dysregulated angiogenesis. They are most often solitary but rarely could be multiple, in which case an underlying syndrome (e.g. hereditary haemorrhagic telangiectasia,…

Central Nervous System Infections | Neuro-imaging

Toxoplasmosis

Byepsuadmin August 21, 2014June 14, 2015

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…

Neurodegenerative Disorders

Vascular Dementia

Byepsuadmin June 5, 2015June 14, 2015

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…

Neurodegenerative Disorders

Frontotemporal Dementia

Byepsuadmin June 5, 2015June 14, 2015

Frontotemporal dementia is the most common cause of dementia in patients under the age of 65. There are three different subtypes: 1) behavioural-variant frontotemporal dementia,the most common subtype which is characterised by changes in personality and social conduct; 2) progressive nonfluent aphasia – a disorder of language output that may occur in the absence of…

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