Case Images
Case Notes
History
17 year old female with episode of 5 seconds of an out of body experience, then tilting of vision, general distress, and dizziness (could not walk straight) lasting about 1 hour.Exam
Prior Study
CT Head not availableMR T1-w exam
The T1 weighted post contrast MR sequence was negative with no evidence of foreign tissue lesion to account for seizures
T2-w MR
Abnormal body and tail of the left hippocampus with changes consistent with a recent seizure.
No foreign tissue lesion Is evident
Dicom
Findings
| MR Diffusion | Correct Answer | Your Answer |
|---|---|---|
|
There is evidence of positive MR diffusion within a substantial part of the head, body, or tail of the hippocampus on one or both sides. |
Yes | NA |
|
There is evidence of positive MR diffusion within only a focal segment of any part of either hippocampus on one or both sides. |
No | NA |
|
There is evidence of positive MR diffusion within the anterior thalamic pole nuclei. |
No | NA |
|
There is evidence of positive MR diffusion within the splenium of the corpus callosum. |
No | NA |
|
There is evidence of positive MR diffusion in a recognizable arterial, venous, or transcapillary perfusion zone representing an ischemic FTL cause of the seizure. |
No | NA |
|
There is evidence of positive MR diffusion in a brain mass (usually CNS lymphoma, PTLD, very high grade GBM, etc.) representing a FTL cause of the seizure. |
No | NA |
|
There is evidence of positve MR diffusion in either a focal brain lesion or in the extraaxial CSF spaces to suggest empyema as a basis for the seizure. |
No | NA |
|
Other findings are present more consistent with a diagnosis other than stroke. |
No | NA |
Impression
Expert Answer
All of the above are true.
Your Answer
Recommendations & Acuity
Recommendations
Expert Answer
Proceed with additional MR imaging sequences.
Your Answer
Acuity
Expert Answer
Emergent (Action Necessary now)
