Thrombosis of the deep cerebral venous system in the absence of superficial sinus thrombosis is a very rare disease. The clinical and radiological findings can be diagnostically challenging due to the subtle appearances on computed tomography (CT) scan. Magnetic resonance imaging (MRI) examination is a preferred imaging modality to complement the CT findings for an accurate diagnosis of venous sinus thrombosis. We present a case of this unusual condition which present as unilateral thalamic lesion on CT scan and the role of contrast enhanced MRI with fast spoiled gradient echo (FSPGR) sequence and 3D reconstruction which led to the diagnosis of thrombosis in the deep cerebral venous system.
Thrombosis

Tolosa-Hunt syndrome is typically associated with an infl ammatory lesion in the cavernous sinus or orbital fi ssure, often requiring steroids for symptom resolution. In this report, we describe a case of Tolosa-Hunt syndrome preceded by several years’ history of idiopathic recurrent facial palsies. The spontaneous resolution of THS in our case as well as prior facial nerve involvement supports the hypothesis that Tolosa-Hunt syndrome is part of a spectrum of idiopathic recurrent cranial neuropathy.

Medulloblastoma is the most common form of childhood primary brain tumour arising from the cerebellar vermis. It is classified as WHO grade IV embryonal tumours and currently at least four histological variants have been established. Only few case reports been published on the imaging features of the medulloblastoma with excessive nodularity variant. We report the MRI features of a rare case of medulloblastoma with excessive nodularity in a child which is confirmed by histopathology.

Aged ; Brain Neoplasms ; diagnosis ; pathology ; Central Nervous System Neoplasms ; diagnosis ; pathology ; Fatal Outcome ; Female ; Humans ; Lymphoma ; diagnosis ; pathology ; Meningeal Neoplasms ; diagnosis ; secondary

This is a case of an adult patient with hypertensive intraventricular haemorrhages complicated by hydrocephalus that failed to respond to endoscopic third ventriculostomy (ETV). High-resolution 3D Fast Imaging Employing Steady State Acquisition (FIESTA) magnetic resonance imaging (MRI) revealed underlying multiloculated hydrocephalus. This case report highlights the appropriate sequence and its attributes that offer adequate preoperative information detailing the ventricular system.

A 27 year-old Chinese man, involved in a motor vehicle accident, presented with rapidly progressive pseudobulbar palsy and spastic tetraplegia. Magnetic resonance imaging (MRI) of the brain showed central pontine T2 hyperintensity with an unaffected outer rim, consistent with central pontine myelinolysis. There was no hyponatraemia before MRI and he was neither an alcoholic nor malnourished. Cerebral angiogram confi rmed the diagnosis of right vertebral artery dissection. Vertebral artery dissection should be considered in a case with imaging suggestive of central pontine myelinolysis.

Objective: To delineate and differentiate between late subacute hemorrhage and intracranial lipomas in clinically available conventional and advanced MR sequences. Methods: Two cases of late subacute hemorrhage and two cases of intracranial lipoma were reviewed with CT scans and 3.0T scanner MRI. The sequences evaluated in MRI were T1-weighted (T1W) fast spin echo (FSE), T2-weighted (T2W) FSE, gradient echo T2*-weighted (GRE T2*W) images, diffusion weighted (DWI), apparent diffusion coefficient (ADC) and multivoxel spectroscopy. Results: Late subacute hemorrhage and intracranial lipoma have similar imaging features on T1W, T2W FSE with blooming artefact at the margins on GRE T2*W. However on GRE T2*W sequence, the central area of lipoma demonstrates low signal; while hemorrhage demonstrates high signal. In DWI, late subacute hemorrhage shows hyperintensity; while in lipoma there is loss of signal. Conclusion: Awareness of the potential pitfalls in standard sequence are important, as these entities appear to have similar T1W/ T2W characteristic with blooming artefact on T2*W. Knowing the distinctive central signal intensity pattern on GRE T2W* and DWI is therefore essential to differentiate between these lesions as there are differences to their clinical management.
Magnetic Resonance Imaging

Increase in cross-sectional muscle area of major muscle groups associated by heavy resistance training has been well documented. However, there has been no published article of changes in the inferior orbicularis oculi muscle when heavy resistance training is applied. We present a case of inferior orbicularis hypertrophy detected on MRI in a gentleman who practised heavy resistance training using his lower eyelids.