This is a coronal CT demonstrating a left occipital condyle fracture. Condyle fractures usually occur from high energy, non-penetrating trauma to the head and neck. Of patients presenting with an occipital condyle fracture, approximately 63% will have other neurological deficits, usually involving CNs IX, X, and XI. There are three types of condyle fractures according to the Anderson Montesano Classification: Type I) minimal fragment displacement, Type II) associated with other basilar skull fractures, Type III) avulsion fracture with displacement of fragments.
This is an axial T1 MRI with contrast demonstrating a glomus jugulare tumor growing out of the left jugular foramen. Three cranial nerves traverse the jugular foramen – the glossopharyngeal (CN IX), vagus (CN X) and accessory (CN XI) nerves – and these nerves can be unilaterally affected in the setting of a glomus tumor.
This is a case of lumbar facet arthropathy by Dr. Stephan Ritland, one of my neurosurgeon mentors. Note the hyper intense T2 signal in the facet joints on this axial T2 MRI of the lumbar spine. Follow the link to read about the Ritland submuscular approach for treatment.
This is a T2 MRI C spine demonstrating a “swan neck deformity” – draping of the spinal cord over a kyphotic deformity of the cervical spine. Typically, extensive cervical fusion is required for correction and prevention of deterioration in symptomatic patients.
This is a CT head demonstrating agenesis, or absence, of the corpus callosum. The corpus callosum is a broad band of axons interconnecting the two hemispheres of the brain. Agenesis of the corpus callosum, although rare, is one of the most common brain malformations in human beings. It can be completely asymptomatic, or it can be associated with autism, seizures, and motor, auditory and/or speech symptoms. The anterior corpus callosum has been noted to be more pronounced in musicians and left handed and ambidextrous people.
Baastrup’s syndrome (aka “kissing spines”) results from osteoarthritis of spinous processes (usually lumbar). The spinous processes rub up against each other which leads to hypertrophy and sclerosis. This can cause a patient pain that is exacerbated with extension and relieved with flexion. The disease is named after Christian Ingerslev Baastrup, a Danish radiologist (1855-1950).
This is an axial FLAIR MRI sequence of a third ventricle colloid cyst. These cysts are benign in nature, however they can quickly cause a deadly hydrocephalus by blocking the foramina of Monro and CSF flow out of the lateral ventricles. The hydrocephalus, or ballooning, of the lateral ventricles can cause herniation of the medial temporal lobes across the tentoirum cerebelli, and eventually herniation of the brainstem through the foramen magnum, resulting in death. Treatment includes placement of an external ventricular drain (“EVD”) in the lateral ventricle to relieve hydrocephalic pressure on the brain, followed by endoscopic surgical removal of the colloid cyst.