Cephalic Pain

Migraine headache - Classical migraine (hemicrania) A pulsatile headache that starts in the temple on one side and spreads to involve the whole side of the head. Usually self-limiting, lasting from 30 minutes to several hours Nocturnal attacks of pain in and around the eye, which may become bloodshot and with the nose stuffed up, with lacrimation and nasal watering. Bouts last 6-12 weeks and may recur at the same time each year Unilateral, shooting, drilling headache, associated with...

Multiple Sclerosis Like Lesions

Multiple sclerosis (MS) is a clinical diagnosis that should never be made using neuroimaging alone. In 78-95 of clinically diagnosed MS patients, gadolinium-enhanced magnetic resonance imaging (MRI) features include ovoid periventricular, infratentorial, temporal lobe, and corpus callosum white matter lesions that are isointense to hypointense on Tl-weighted images, and show high intensity on proton density and T2-weighted images. Many conditions have to be taken into account in the...

Metastatic brain tumors

Although intraventricular neurocytomas have a more benign course, they are more often subject to hemorrhage than oligodendrogliomas, which may suggest the diagnosis Bronchial carcinomas spread to the CNS in 30 of cases oat-cell carcinoma is the most frequent, whereas squamous-cell carcinoma is the least frequent subtype to metastasize to the brain It is estimated that 18-30 of patients with breast cancer will develop brain metastases Third most common neoplasm, with a propensity for metastatic...

Sciatica

Intervertebral disk dis- In most cases, sciatica is disk related and is caused by ease degenerative changes of the two lower lumbar motion Spinal stenosis In many cases, caused indirectly by a disorder of the Spondylolisthesis Spondylitis Vertebral tumors Extravertebral retroperitoneal tumors Sciatic nerve damage due to injection Is usually bilateral, and is little influenced by position changes and or traction Nerve root irritation is bilateral, and not influenced by motion or traction. Night...

Scar Versus Residual Disk

Magnetic resonance imaging (MRI) without intravenous contrast is at least as good as contrast computed tomography (CT) in distinguishing scar tissue from disk material, yielding an accuracy of 83 . The addition of gadolinium diethylene-triamine-penta-acetic acid (Gd-DTPA) enhancement further increases the diagnostic accuracy from 89 to 96 . Overall sagittal and axial Tl-weighted pre-Gd-DTPA and post-Gd-DTPA MRI remains the single most effective method of evaluating the postoperative lumbar...

Herpesviruses

Herpes simplex virus The reactivation and replication of HSV leads to intype 1 (HSV-1) flammation and extensive necrosis and edema of the medial temporal lobe and orbital surface of the frontal lobe of immunocompetent patients, producing the characteristic clinical picture. Patients develop fever, headache, irritability, lethargy, confusion and focal neurological signs, such as aphasia, motor and sensory deficits, and seizures (major motor, complex partial, focal, and absence attacks). CSF...

Fig 1 Suprasellar lesions neoplastic

Coronal T1 WI with a pituitary macroadenoma in close relationship with the optic chiasm presenting a heterogeneous, post-contrast high intensity signal. 3. Pituitary macroadenoma. Sagittal T1 WI shows a pituitary tumor with a heterogeneous postcontrast high intensity signal with cystic and or necrotic features in its posterior section filling the suprasellar cisterns and exerting compression on the optic chiasm. 4, 5. Craniopharyngioma. A suprasellar...

Clinical Grading Scales in Subarachnoid Hemorrhage

Conscious, with or without signs of bleeding in the subarachnoid space I Drowsy, without significant neurological deficit II Drowsy, with significant neurological deficit III Major neurological deficit, deteriorating, or older with preexisting Moribund or near-moribund, failing vital centers, extensor rigidity V Asymptomatic or mild headache I Moderate to severe headache, nuchal rigidity, may have oculomotor Confusion, drowsiness, or mild focal signs III Coma, moribund appearance, and or...

Fungal Infections

Zygomycetes (especially Mucor, Rhi-zopus) Cryptococcus neofor- The point of entry for Cryptococcus is the lungs. Pul-mans monary infection is not evident in healthy individuals, but becomes invasive in immunocompromised patients. Cryptococcal meningitis is the most common CNS infection (50 )in chronically immuno-suppressed non-AIDS patients. Cryptococcal meningitis presents as a chronic febrile syndrome with headache. The ensuing meningoencephalitis reflects cognitive changes or dementia,...

Cerebellopontine Angle

Acoustic schwannoma Most common mass, up to 75 of cases Meningioma Second most common lesion, up to 10 of cases Also known as congenital cholesteatoma or pearly tumor 5-7 Also known as glomus jugulare tumor a chemodec-toma arising from the jugular foramen and extending into the CPA 2-10 2 - 5 . The trigeminal and facial nerves are probably the most common sites of nonacoustic schwannomas. Other cranial nerves involved are VI, IX, X, XI, and rarely XII 1 primary in the CPA or extension via the...