Christopher Buckle MD - DocNeuro

Labyrinthitis Ossificans

Christopher Buckle MD — Tue, 15 Jul 2014 14:59:22 +0000

What anatomic structure of the middle or inner ear is abnormal in this patient with hearing loss and a history of childhood meningitis? A. Ossicular chain B. Otic capsule C. Oval window D. Cochlea Answer: This cochlea is ossified; the cochlea is normally fluid filled and therefore low density on CT. (A) axial non contrast […]

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MCA aneurysm

Christopher Buckle MD — Tue, 15 Jul 2014 14:16:12 +0000

History : 45 year old man with sudden onset of severe headache. What is the most likely etiology for this patient’s intraventricular hemorrhage? A. cavernous malformation B. aneurysm C. hypertensive intracranial hemorrhage D. AVM Answer: MCA Aneursym. The images demonstrate an intensely vascular mass in the right supraclinoid region. The mass appears […]

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ADEM

Christopher Buckle MD — Mon, 03 Feb 2014 04:01:38 +0000

ADEM (acute disseminated encephalomyelitis) is an autoimmune demyelinating disorder distinct from multiple sclerosis or Devic’s disease. Figure: Axial FLAIR at the level of the midbrain (A) and the thalamus (B) demonstrate increased signal in the left anteromedial thalamus (red arrow) and ventral midbrain (white arrow). Axial postcontrast T1 demonstrates no enhancement of the thalamic signal […]

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Tumefactive multiple sclerosis

Christopher Buckle MD — Sat, 07 Dec 2013 19:55:18 +0000

Tumefactive multiple sclerosis (MS) is an unusual but important manifestation of multiple sclerosis. This is a patient with tumefactive MS. Notice the incomplete rim enhancement around the right frontal mass on the T1 post contrast sequence. This incomplete rim enhancement is classic for a tumefactive demyelinating lesion as opposed to a neoplasm. A. T1 precontrast and […]

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Carotid Artery Dissection, MRA

Christopher Buckle MD — Thu, 21 Feb 2013 19:41:01 +0000

Carotid/vertebral artery dissection is an underdiagnosed disease that can result in substantial morbidity. It has an incidence of 1-1.5/100000 and disproportionately affects young patients. Diagnosis is challenging clinically because the symptoms are often non specific and most commonly include unilateral headache and neck pain with more specific (but less sensitive) symptoms including Horner’s syndrome, cranial […]

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Diffuse Axonal Injury

Christopher Buckle MD — Thu, 21 Feb 2013 19:32:22 +0000

The third T in the 3T trauma framework (see cases on epidural hematoma and penetrating trauma) refers to “other targets” and concerns delayed complications of traumatic brain injury. These competitions include hydrocephalus, ventriculitis and diffuse axonal injury. Diagnosis: Diffuse Axonal Injury Figure 1: (a, red arrow) non contrast head CT shows a small hemorrhagic contusion […]

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Non-penetrating head trauma

Christopher Buckle MD — Thu, 21 Feb 2013 19:25:02 +0000

Trauma is the sixth leading cause of death world wide. Non-penetrating head trauma is the most common form of trauma and involves forces that impact but do not penetrate the parenchyma. Motor vehicle collisions and falls are the most common forms. Head injuries are a common consequence of nonpenetrating trauma, occurring approximately 30% of the […]

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Penetrating Head Trauma

Christopher Buckle MD — Thu, 21 Feb 2013 19:17:19 +0000

Trauma accounts for approximately 1 in 3 ER visits nationwide and is a major public health problem. It is the leading cause of death amongst youth and young adults and a major source of morbidity and lost productivity. There are two basic kinds of trauma – penetrating and non-penetrating head trauma. Diagnosis: Penetrating head trauma […]

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Radiation Necrosis

Christopher Buckle MD — Thu, 21 Feb 2013 18:57:06 +0000

Radiotherapy is commonly used as an adjuvant therapy to surgery and chemotherapy in the management of primary brain neoplasms. Radiation destroys cells and damages the tumor blood supply. Addition of radiation therapy to surgery has been shown to improve GBM survival from 3-7 to 7-12 months. Diagnosis: Radiation necrosis Figure 1: axial (a) and sagittal […]

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Residual/Recurrent Tumor

Christopher Buckle MD — Thu, 21 Feb 2013 18:46:14 +0000

Imaging plays an important role in the diagnosis and management of patients with primary brain neoplasms. In particular, imaging is typically performed within 48 hours of tumor resection. Diagnosis: Residual GBM after surgery Figure 1: (a, red arrrow) Pre and immediate post operative (b, blue arrow) MRI imaging of a GBM demonstrates decreased but persistent […]

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