69-year-old male with a past medical history significant for HTN, HLD, MI (S/p stents 2016), and diabetes (on metformin) who presented to the ED for left-sided facial droop and upper/lower extremity weakness. Patient was in his usual state of health when he went to take a nap. His wife saw him walk into the bedroom at 3:00pm (Last known normal) and heard him yelling for help when he woke up around 4:30pm with left sided weakness.

1-2

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58-year-old female who presented with headaches and loss of consciousness.

1-3

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Cluster headache, not intractable, unspecified chronicity pattern.

1-4

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Left sided weakness.

1-5

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44-year-old male with 3 month history of intermittent pain and redness within the left eye.

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Worklist 2

2-1

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Acute onset dysphasia, worsening lower extremity weakness, urinary incontinence. Functional decline over the past 6 months with poor gait and cognition. Dementia with frontal release signs, bulbar weakness, dysarthria.

2-2

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26-year-old female with history of Chiari malformation and headache.

2-3

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Altered mental status and double vision. History of AML and breast cancer with anorexia and weight loss.

2-4

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Unusual uncomplicated headaches. Chiari malformation with suboccipital craniotomy and decompression.

2-5

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Severe headaches waking from sleep, hypertension, migraine history.

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Worklist 3

3-1

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New paresthesias in the extremities.

3-2

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Worsening vision. History of recent TIA. Right leg difficulty. Encephalopathic.

3-3

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Antiphospholipid lipid syndrome. Protein C deficiency. Slurred speech, difficulty walking, arm and hand numbness and weakness. The patient had recent gastric bypass surgery and has not been eating well for 2 weeks.

3-4

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70-year-old woman with visual disturbance, b/l cataracts, HTN, HLD, CAD (MI s/p stent '13), who presents to ED with 3d of gradual onset right-sided weakness and numbness.

3-5

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A 7-year-old with Pre B ALL STATUS post BMT and trisomy 21, altered mental status. Over the past couple days, he had tremors. Patient on Tacrolimus (FK-506).

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Worklist 4

4-1

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33-year-old male with brain lesion.

4-2

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A 47-year-old female underwent a skull base wand protocol for diplopia.

4-3

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Intraventricular mass. Pre-op evaluation. Headaches.

4-4

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69-year-old female with left eye pain, vertigo, and numbness in the left upper and lower extremity.

4-5

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57-year-old male who initially presented to an outside hospital with facial droop and was found to have right frontal lobe mass, now presenting for preoperative imaging.

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Worklist 5

5-1

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Fall with concern for cervical spine trauma.

5-2

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Pedestrian struck. Only reacts to painful stimuli. GCS of 5.

5-3

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Patient with fall and suspected intracranial hemorrhage (ICH).

5-4

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Young 12-year-old passenger in a head on motor vehicle collision. Lacerations to the face, scalp hematoma, fixed equal pupils. L1 fracture.

5-5

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28-year-old male follow-up after opioid overdose.

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Worklist 6

6-1

Preview Case

History of shunted hydrocephalus, status post fall.

6-2

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New right-sided visual neglect. Primary parkinsonism.

6-3

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A 27-year-old female with acute worsening of chronic migraines for the past week.

6-4

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Frontal mass.

6-5

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32-year-old male with a history of complex thoracolumbar spinal issue including history of thoracolumbar stenosis, for which he underwent thoracic-L4 fusion in 2007. He complains primarily of low back pain and right lateral leg pain. On examination, he is neurologically intact.

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Worklist 7

7-1

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Not following commands, fever, post-ictal.

7-2

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Left-sided facial weakness.

7-3

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45-year-old male with a history of alcohol abuse who presents with dizziness, unsteadiness, left facial numbness, fever and diplopia.

7-4

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53-year-old man with "transient ischemic attack".

7-5

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14-year-old male with history of asthma presenting with left preseptal soft tissue swelling.

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Worklist 8

8-1

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35-year-old woman who presents with blurred vision for the past 2 months.

8-2

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Asymptomatic. Clival lesion seen on post-trauma CT scan.

8-3

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31-year-old female with a history of a clival mass undergoing preoperative evaluation.

8-4

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24-year-old male with right-sided ear fullness and chronic left-sided hearing loss.

8-5

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Mass follow-up. Hypertension, diabetes.

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Worklist 9

9-1

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37-year-old male presents to the ED with back pain since February. States seeing orthopedic surgeon. States had 2nd steroid injection Thursday. Seen at PT first Monday and taking tramadol, steroids and muscle relaxants. States last MRI in January. Herniated disc. States tingling left leg/numbness for 1 week. Denies weakness.

9-2

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30-year-old female with no significant PMH who presents with first symptom of constipation. She then developed intermittent whole leg numbness, first the left leg, then the right leg. Her sensation would return after shaking her legs multiple times. She then developed back pain and leg pain that is described as pressure, as if someone is grabbing her legs and holding them in a vice. At present, she has severe crushing pain in her hips. She was started on gabapentin that has not helped. Nothing makes the pain better. Sitting and moving makes the pain worse. She has decreased sensation in her legs, and her legs feel heavy to the point where she has had multiple falls a day. About 1 month ago, she began having to use a walker to assist her. She also endorses difficulty with initiation of urination and she does not feel that she is emptying fully. For the last 2 weeks, she has noticed intermittent decreased sexual feeling.

9-3

Preview Case

20-year-old male with a skin lesion of the back of the neck who presented to clinic with 3 weeks of progressively worsening weakness of his left lower extremity. The patient and his parents indicate that approximately 3 weeks ago he started requiring lifting his leg with his hands when he was moving from his wheelchair and standing has been significantly more difficult. He had 3/5 strength in his left lower extremity on exam, a positive Babinsky sign and clonus at the left ankle.

9-4

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Patient with history of pancreatic adenocarcinoma status post Whipple surgery, presenting with progressive lower extremity weakness bilaterally and loss of bladder control.

9-5

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54-year-old male with a past medical history of HTN (hypertension) who presents with bilateral fingertip numbness and weakness (since he feels like he can't feel them) since yesterday morning. Having a hard time holding objects and tying his shoes.

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0 / 5 Cases

Worklist 10

10-1

Preview Case

Severe headache over the past several days. Hypertension to 200/120. History of severe migraines.

10-2

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Left lower extremity weakness. NIH stroke scale 3.

10-3

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Stroke suspected. Slow to respond to questions and cannot spell WORLD backwards.

10-4

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67-year-old man with history of CAD status post CABG (unknown anatomy), PAD, HTN, HLD, alcoholic liver disease referred for TEE with a 1.6 cm mobile echogenic mass on the atrial aspect of the posterior mitral annulus presents with fever and confusion.

10-5

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Diabetes. Gait problems leaning to the right. Hypertension.

Wk 10, Articles

Course Evaluation

Brain & Spine Neuroradiology Fellowship Certificate

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Brain and Spine Neuroradiology Practice Cases

Wk 3, Articles

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Report

Follow-Up of Emergency Department MRI Scans Suggesting New Diagnosis of CNS Demyelination

Prediction of a multiple sclerosis diagnosis in patients with clinically isolated syndrome using the 2016 MAGNIMS and 2010 McDonald criteria: a retrospective study

Acute Cortical Lesions in MELAS Syndrome: Anatomic Distribution, Symmetry, and Evolution

MELAS

Treatment-related transient splenial lesion of the Corpus Callosum in patients with neuropsychiatric disorders: a literature overview with a case report

Differentiating neuromyelitis optica from other causes of longitudinally extensive transverse myelitis on spinal magnetic resonance imaging

Posterior Reversible Encephalopathy Syndrome and Reversible Cerebral Vasoconstriction Syndrome

MRI evaluation of pathologies affecting the corpus callosum: A pictorial essay

Characteristics of Cerebral Microbleeds

Cytotoxic Lesions of the Corpus Callosum That Show Restricted Diffusion: Mechanisms, Causes, and Manifestations

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