Tag Archives: Aphasia
Diagnosis: Clinical and imaging features plus laboratory findings Clinical features: Gradual onset & progressive. Seizures & aphasia may occur Occurs in the setting of immunosupression: e.g. HIV infection/AIDS, immunosupressant medications, Findings on Investigations: JC virus in CSF: by PCR MRI: White matter lesions, usually asymmetric but bilateral, periventricular and subcortical involvement of U fibres, spares … Continue reading Progressive Multifocal Leukoencephalopathy (PML)
Frontotemporal Dementia (FTD)
Synonyms: a.k.a. Frontotemporal lobar dementia FTLD Diagnosis: Clinical features, plus supportive imaging Clinical features: Behavioural symptoms: Progressive change in personality Decline of reasoning Social inappropriateness Primary progressive aphasia: Anomia (inability to retrieve nouns upon demand), Agrammatism (inappropriate word order or use of prepositions), Loss of semantic knowledge about words and objects Clinical variants: progressive nonfluent … Continue reading Frontotemporal Dementia (FTD)
Fungal Intracranial Abscess
Candida abscess: Diagnosis: Biopsy or blood culture isolation of organisms Treatment: Fluconazole, amphotericin B Cryptococcosis (Cryptococcus neoformans): See under Cryptococcosis (Cryptococcus neoformans), Cryptococcal meningitis & related Aspergillosis a.k.a. Aspergillus fumigatus or flavus: Diagnosis: Suggested by MRI, but confirmed by biopsy Pathology: Biopsy: Within distribution of anterior or middle cerebral artery. Multiple. Necrosis, hemorrhage. … Continue reading Fungal Intracranial Abscess
Brain Abscess
Synonyms: Intracranial abscess a.k.a. intracerebral abscess: Diagnosis: Suggested by imaigng. Confirmed by biopsy and culture Clinical features: Presents with focal neurological deficits: weakness, aphasia, neglect May present with headache or seizure Meningismus in <30% Pathology: Biopsy: Necrosis with inflammation (neutrophils & later macrophages & lymphocytes), rim of fibrosis (if absent this is cerebritis) Surrounding gliosis … Continue reading Brain Abscess
Transient Ischemic Attack
Diagnosis: Sudden neurological focal deficit of vascular origin lasting <24 hrs (usually lasts <1 hr), with normal diffusion weighted MRI (DWI). PWI: may show decreased perfusion. Investigations to Consider: Blood tests: FBC, Coagulation screen, Blood Glucose, Blood chemistry panel, Fasting: Cholesterol, Lipids, glucose ESR: vasculitides, giant cell arteritis. Consider Homocystein, vasculitic screen, thrombophilia screen Extracranial … Continue reading Transient Ischemic Attack
Intracerebral Hemorrhage
This section will discuss intracerebral hemorrhage; the commonest type of hemorrhagic stroke. Hemorrhagic stroke is a broad category of stroke and includes intracerebral hemorrhage and subarachnoid hemorrhage. Together these two conditions represent 13-20% of stroke cases with the rest being due to ischemic stroke. Intracerebral hemorrhage is more common than subarachnoid hemorrhage with the later … Continue reading Intracerebral Hemorrhage
Ischemic Stroke
Ischemic stroke is the commonest form of stroke. It represents infarction of the brain or spinal cord due to interruption of blood supply. There are many causes including embolism of material such as thrombus, cholesterol or rarely other material. Other mechanisms include thrombosis and miscellaneous causes of interruption of blood flow. The symptoms vary depending … Continue reading Ischemic Stroke
Viral Encephalitis
Viral encephalitis is the commonest cause of encephalitis. The general features and causes of encephalitis are described in a separate section. Here we discuss the various viral encephalitides. HSV Encephalitis: Diagnosis: Clinical findings combined with MRI features and isolation of virus by PCR or pathology Findings on investigations: CT: Low density in: Insular regions, … Continue reading Viral Encephalitis
Encephalitis
Encephalitis is the term used to describe an inflammatory process of the substance of the brain. This distinguishes it from meningitis which is an inflammatory process of the coverings of the brain. There are patients who have inflammation of both areas and this is described as meningo-encephalitis. Patients with encephalitis and those with meningitis present … Continue reading Encephalitis