This is a difficult question. Toxoplasmosis is the most common cause of brain lesions in HIV patients. However, around 80% of toxoplasmosis cases involve multiple lesions and the history is suggestive of lymphoma. Cerebral tuberculosis is much less common than …
Fluctuating confusion/consciousness? – subdural haematoma This patient has a number of risk factors for a subdural haematoma including old age, alcoholism and anticoagulation. Korsakoff’s syndrome and Wernicke’s encephalopathy do not usually cause headaches. Head injury Types of traumatic brain injury: …
Post-lumbar puncture headache Headache following lumbar puncture (LP) occurs in approximately one-third of patients. The pathophysiology of is unclear but may relate to a ‘leak’ of CSF following dural puncture. Post-LP headaches are more common in young females with a …
Facial nerve Supply – ‘face, ear, taste, tear’ face: muscles of facial expression ear: nerve to stapedius taste: supplies anterior two-thirds of tongue tear: parasympathetic fibres to lacrimal glands, also salivary glands Causes of bilateral facial nerve palsy sarcoidosis Guillain-Barre …
Dystrophia myotonica – DM1 distal weakness initially autosomal dominant diabetes dysarthria The slow-relaxing grip may be noticed on initial hand-shake with the patient and is typical of myotonic dystrophy. Dysarthric speech is secondary to myotonia of the tongue and pharynx …
This patients age, blood pressure and duration of symptoms would put her in a higher risk category. Current guidelines advocate specialist review within 24 hours Transient ischaemic attack NICE issued updated guidelines relating to stroke and transient ischaemic attack (TIA) …
Horner’s syndrome – anhydrosis determines site of lesion: head, arm, trunk = central lesion: stroke, syringomyelia just face = pre-ganglionic lesion: Pancoast’s, cervical rib absent = post-ganglionic lesion: carotid artery Horner’s syndrome Features miosis (small pupil) ptosis enophthalmos* (sunken eye) …
There results are consistent with normal CSF – an alternative diagnosis should be considered Meningitis: CSF analysis The table below summarises the characteristic cerebrospinal fluid (CSF) findings in meningitis: Bacterial Viral Tuberculous Appearance Cloudy Clear/cloudy Fibrin web Glucose Low (< …
Transfer factor raised: asthma, hemorrhage, left-to-right shunts, polycythemia low: everything else Transfer factor The transfer factor describes the rate at which a gas will diffuse from alveoli into blood. Carbon monoxide is used to test the rate of diffusion. Results …
Brain lesions The following neurological disorders/features may allow localisation of a brain lesion: Gross anatomy Parietal lobe lesions sensory inattention apraxias astereognosis (tactile agnosia) inferior homonymous quadrantanopia Gerstmann’s syndrome (lesion of dominant parietal): alexia, acalculia, finger agnosia and right-left disorientation …