Case Challenge

Brain

Neuro

Stephen J Pomeranz

Gain confidence interpreting Brain MRI w/ practice cases from MRI Online. Quiz yourself using real-world, interactive scrollable cases & earn CME. Try it free!

Case Review

Neuroradiology

Post-Course Activities

This Power Pack is comprised of 35 unique Brain MRI cases that you can scroll through in our diagnostic web viewer to determine your findings. Quiz yourself and earn CME.

Brain MRI Cases

Case 6 - 43-year-old female presents with neck pain

<div><figure class="wp-block-image"><img src="https://process.fs.teachablecdn.com/ADNupMnWyR7kCWRvm76Laz/resize=width:750/https://www.filepicker.io/api/file/VMffvSR5RaiZxbWnWbQE" alt="Brain 2.png"></figure>MOST LIKELY DIAGNOSIS: Glomus jugulare tumorThis 43-year-old female presents with neck pain. Try to work through the case looking at just the first four images, before looking at the same images with arrows indicating key findings.CLINICAL CONSIDERATIONS:Q1 &#8211; The differential diagnosis includes all of the following, except:(a) Glomus(b) Meningioma(c) Epidermoid(d) SchwannomaQ2 &#8211; Glomus jugulare may present as any of the following, except:(a) Vernet syndrome(b) Collet-Sicard syndrome(c) Horner syndrome(d) Bell&#8217;s palsyQ3 &#8211; Glomus jugulare may demonstrate any of the following, except:(a) Salt-and-pepper appearance on T1 MRI(b) Salt-and-pepper appearance on T2 MRI(c) Minimal or no enhancement on MRI(d) Erosion of the jugular spine on CTGlomus tumor is a paraganglioma of the jugular fossa which may arise from Jacobson&#8217;s nerve or Arnold&#8217;s nerve. It may result in cranial neuropathies of the skull base including those in the jugular foramen 9, 10, 11 (Vernet syndrome) or in larger lesions may also involve 12 (Collet-Sicard syndrome). Horner syndrome may also be seen secondary to involvement of autonomics closely associated with the carotid and jugular walls. Bell&#8217;s palsy involves the 7th nerve complex which is more superior in location and exits through the internal auditory canal.Glomus tumor markedly enhances and may erode the jugular spine. The salt-and-pepper appearance due to high vascularity and multiple flow voids in a classic appearance.It may be part of endocrine adenomatosis IIB/III syndrome and 6-8% are multiple.A1 &#8211; (c) EpidermoidA2 &#8211; (d) Bell&#8217;s palsyA3 &#8211; (c) Minimal or no enhancement on MRICLICK "MARK COMPLETE" TO ADVANCE</div>