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 18 - 63-year-old female presents with ataxia and memory disorder

<div>HISTORY:&#160;This 63-year-old female presents with ataxia and memory disorder.(QUIZ ANSWER) NOT A LIKELY DIFFERENTIAL:&#160;Alzheimer's dementia.Using the&#160;diagnostic web viewer, we have provided images that assist in telling our clinical story. Areas of significance are indicated below.FINDINGS: The caudate heads and putamen are atrophic. The inter-caudate to frontal horn distance of 1.5cm is below the normal range.&#160;Mild vermian and cerebellar atrophy.&#160;Frontoparietotemporal pattern of cerebral atrophy with relative preservation of hippocampal volume.&#160;Diffusion-weighted images are without a diffusion restrictive defect.&#160;No obstructive hydrocephalus.&#160;Nigral and pallidal iron stores are maintained.&#160;Mild midbrain volume loss.&#160;Pontine volume is maintained.&#160;No extraaxial collections or hemorrhage.&#160;Cerebral hemispheres and deep nuclei are without hemorrhage, mass or edema. Partial empty sella. No extraocular muscle enlargement. No suprasellar masses or chiasmal compression. No masses in the masticator, parapharyngeal or pharyngeal mucosal spaces.&#160;IMPRESSION: Atrophy of the putamen and caudate heads with cerebellar trophy may represent a neurodegenerative process. Differential could include frontal lobar atrophy, corticobasal degeneration, multisystem atrophy, Wilson's disease. Distribution of findings which spares the hippocampi, is atypical for Alzheimer's.&#160;No obstructive hydrocephalus, no NPH.&#160;Midbrain iron stores are preserved. No supportive findings of idiopathic Parkinson's.&#160;No evidence of acute supra- or infratentorial ischemia.</div>

Case

Which of the following is not a likely differential in this case?