Neuroanatomy
Dr Raymond Chang
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Intention Tremor
As one can appreciate in this video, this middle-aged man has right-sided intention tremor. The right index finger shows exaggerated tremor when approaching the target, i.e. his nose and physician’s finger. Please note that the examiner should place his finger at around one arm’s length from the patient. This is so that the patient could…
Horizontal Nystagmus
In the first video, the patient has both horizontal nystagmus and vertical “down-beat” nystagmus. In the second video, the patient has a torsional nystagmus when looking to her right hand side. Discussion of the sign Nystagmus is defined as a rhythmic oscillation of the eyes. It usually consists of a slow drifting phase in one direction and a…
Osmotic Demyelination Syndrome
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…
Upper Limbs
Subtitles in English for this video can be displayed by clicking on (first button on the bottom right hand corner of the video). Inspection of the Upper Limbs After adequate exposure, one should then lay the patient’s arms out comfortably. The examiner should stand at the end of the bed / facing the patient if the patient is…
Ischaemic Changes of Different Anatomical Regions or Vascular Territories
Bilateral watershed infarct The non-contrast CT brain shown is from a patient with bilateral watershed infarct. Here, chronic ischaemic changes can be seen along the external or cortical watershed zones (Figures 1 and 2). These “borderzones” is where the terminal vasculature of the anterior cerebral artery and middle cerebral artery meet as well as where the middle…
Ataxic Wide-based Gait
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…