Managing patients or managing the results of ancillary tests?
Figure 18.1 Case 1. Brain MRI FLAIR (a) and T2 sequences (b) showing punctate subcortical white matter lesions. None were located on the cerebellum or in the cerebellar or vestibular…
Vascular dementia and vascular cognitive impairment
Figure 15.1 Brain CT showing two cortical strokes (left frontal lobe and right parieto-frontal lobe) and several subcortical vascular lesions. Discussion This patient had recurrent strokes and imaging evidence of…
Antithrombotic management of recurrent atherothrombotic cerebrovascular disease
Figure 6.1 MRI diffusion-weighted imaging shows acute ischemia in the primary motor cortex and in neighboring white matter along the MCA–anterior cerebral artery (ACA) boundary zone (arrow). Figure 6.2 CTA…
Dilemmas in endovascular stroke therapy
Figure 8.1 MRI scans of the head. (a) Diffusion-weighted MRI scan demonstrated minimal restricted diffusion involving the left posterior limb of the internal capsule. (b) The perfusion-weighted MRI demonstrated a…
Underdiagnosis of reversible cerebral vasoconstriction syndromes
– Eclampsia-associated vasoconstriction – Drug-induced angiitis (“angiitis” is a misnomer as there is no vessel inflammation) – Migraine “angiitis” (again, a misnomer) – Thunderclap headache with reversible vasospasm – CNS…
Managing hemorrhagic stroke
Figure 17.1 CT scan of the head demonstrating an acute intracranial hemorrhage in the medulla (a, axillary image), extending into the lower pons (b, sagittal image). The remainder of the…
The diagnosis and overdiagnosis of cerebral vasculitis
Figure 11.1 Reversible cerebral vasoconstriction syndrome. (a) First brain MRI FLAIR axial section showing subcortical parieto-occipital hyperintensities. (b) Angio-MRI showing segmental narrowing of both middle, left anterior and posterior cerebral…
When the diagnostic image is not diagnostic
Figure 4.1 Non-contrast head CT axial image at the level of the basal cisterns demonstrates hyperdensity in the expected location of the basilar artery (arrow). The clinical history and abnormal…
Pitfalls in the diagnosis of subarachnoid hemorrhage
Figure 16.1 Axial cranial computed tomography showing diffuse high density collection in the suprasellar cistern extending bilaterally into the Sylvian fissures consistent with subarachnoid hemorrhage. Discussion Subarachnoid hemorrhage (SAH) accounts…
Stroke and patent foramen ovale: the conundrum of closure
Figure 10.1 Acute brain magnetic resonance imaging diffusion-weighted (a) and apparent diffusion coefficient map (b) images showing evidence of acute ischemic lesions in right frontal cortex and para-ventricular white matter…
