Carpal Tunnel Syndrome

The carpal tunnel syndrome should be considered when there is any unexplained pain or sensory disturbance (e.g., intermittent numbness and acroparesthesia of the hand that is worse at night) and weakness of the abductor pollicis brevis, the lateral two lumbricals, the opponens polli-cis, and the flexor pollicis brevis muscles. Carpal tunnel syndrome occurs as a result of compression of the median nerve beneath the carpal tunnel ligament, and affects 1 of the population. The following physical...

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...

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 differential...

Syndrome of Inappropriate Secretion of Antidiuretic Hormone and Diabetes Insipidus

The syndrome of inappropriate secretion of antidiuretic hormone SIADH involves the release of antidiuretic hormone ADH at levels inappropriate for a low serum osmolality. Due to continued water ingestion, the elevated ADH results in water retention, hyponatremia, and hypo-osmolality. SIADH results from partial damage to the supraoptic and paraventricular nuclei or neighboring areas, or from production of ADH by tumor or inflammatory tissue outside the hypothalamus. The laboratory criteria for...

Causes of Horners Syndrome

Horner's syndrome is an interruption of the sympathetic supply to the eye, resulting in the classic triad of ptosis, miosis, and anhydrosis. - Amyotrophic lateral sclerosis or Lou Gehrig disease Hypothalamus to upper thoracic cord E.g., hemispherectomy massive infarction may cause The sympathetic and spinothalamic pathways in the brain stem lie throughout their course next to each other. Horner's syndrome here is therefore frequently associated with contralateral pain and temperature loss E.g.,...

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...

Spinal Intradural Cysts

Intraspinal neurenteric cysts form a spectrum that merges with intraspinal teratomas and intraspinal dermoids and epidermoids. More than 60 of the cases are diagnosed in the first 20 years of life 44 are located totally or partially in the cervical spinal canal, 37 are located in the thoracic spinal canal, and 19 in the lumbosacral spinal canal. The neurological signs and symptoms of a slowly progressing mass are associated by congenital anomalies, such as thickened or pigmented skin, a...

Multifocal White Matter Lesions

Hypertension and ischemic white matter lesions leukokraurosis Increases with age, and has also been seen with chronic hypertension. There are two types of ischemic white matter lesions - Lesions involving the watershed distribution of the major brain arteries - Lesions caused by intrinsic disease of the small penetrating medullary arteries arteriolar sclerosis Enlargement of these perivascular spaces with age and hypertension, associated with thinning, pallor and atrophy of the adjacent myelin,...

Skull Base

Osteopetrosis Paranasal Sinus

Extracranial lesions - Nasal, paranasal sinus malignant tumors Orbital plates, frontal bones, cribriform plate, planum sphenoidale Occur in up to 30 of anterior skull base cases. Carcinomas represent 98 of adult nasopharyngeal tumors Squamous cell carcinomas 80 , adenocarcinomas 18 Rhabdomyosarcoma the most common soft tissue sarcoma in children up to 35 of these lesions occur here Esthesioneuroblastoma, or olfactory neuroblastoma arises from the bipolar sensory cells and is histologically...

Postoperative Brain Scar Versus Residual Brain Tumor

Extracellular Methemoglobin Mri

There is nothing more frustrating for the neurosurgeon than a postoperative CT scan or MRI showing residual tumor after a supposedly complete resection. Granulation tissue, which enhances on CT and MRI due to its fi-brovascular nature, develops 72 hours after surgery. After that time, it is consequently difficult to distinguish between enhancing surgical bed tissue and marginal residual tumor, assuming that there was preopera-tive tumor enhancement. The scan enhancement may persist for several...

Posterior Fossa Tumors

Posterior Fossa Ependymoma Mri

Differentiation between medulloblastoma, ependymoma, and astrocytoma based on their radiological characteristics Fig. 3 . Hypodense nodule enhances cyst does not 4 th ventricle, superior medullary velum 1. Medulloblastoma. Axial MRI T1 WI shows a solid space-occuping lesion with a moderate signal intensity on T2WI which occupies the area behind the 4th ventricle exerting pressure on it. 2. Ependymoma. Axial MRI T1 WI shows a multilobular space-occuping lesion with solid features, which are...