Online newspaper of professor Yasser Metwally

Neurofibromatosis type 2 (968 KB)
A 22 years old male patient presented clinically with bilateral tinnitus, headache, bilateral diminution of hearing, bilateral papilledema, bilateral facial nerve palsy, bulbar cranial nerves dysfunction, right sided cerebellar manifestation and bilateral long tract dysfunction.

Neurofibromatosis type 1 (557 KB)
16 years old female patient presented clinically with bilateral marked diminution of vision, mid-dorsal pain, grand mal fits and poor scholastic achievement. Examination revealed bilateral primary optic atrophy, scanty café au lait spots and some cutaneous neurofibromatosis.

Postinfectious cerebellitis (370 KB)
A 6 years old male patient presented clinically with cerebellar ataxia and headache characteristic of increased intracranial pressure of acute onset 3 weeks following non-specific viral infection from which he fully recovered. Clinical examination revealed trunk, gait, limb ataxia and nystagmus. Fundus examination revealed bilateral papilledema. Within one week of hospitalization and non-specific supportive treatment the patient fully recovered and was discharged.

Glomus jugulare tumor (paraganglioma) (920 KB)
A 43 years old male patient presented clinically with tinnitus in the right ear with bulbar, facial and trigeminal nerve dysfunction. Systemic examination revealed elevated blood pressure, with headache and tachycardia.

Ruptured anterior communication artery aneurysm (553 KB)
A 40 years old male patient found in deep coma on the toilet in the bathroom. 

Acute idiopathic transverse myelitis (519 KB)
A 22 years old male patient presented with quadriplegia with a high cervical sensory level of acute onset. The neurological disability occurred 10 days following an attack of flu.

Acute idiopathic transverse myelitis (774 KB)
A 35 years old female patient presented with paraplegia with a high dorsal sensory level of acute onset. The neurological disability occurred 10 days following rabies vaccination.

Spinal multiple sclerosis (885 KB)
A 40 years old patient with relapsing remitting spinal multiple sclerosis (relapsing remitting partial myelopathy). MRI examination of the brain revealed definite asymptomatic brain involvement. Recently the myelopathy became persistent and progressive.

Herpes simplex encephalitis (1680 KB)
A 40 years old female patient presented clinically with fever, grand male fits, disturbed level of consciousness and meningeal irritation signs.

Hypertensive cerebral hemorrhage (893 KB)
A 64 years old female patients presented clinically with sudden onset of right hemiplegia and global aphasia.

Congenital craniocervical anomalies (assimilation of atlas) (779 KB)
A 13 years old male patient presented clinically with atrophy of the small muscles of the hands, bulbar cranial nerve manifestations and cerebellar manifestations. Physical examination revealed a short neck, low hairline, painful torticollis, restricted neck motion, and a loss of the normal cervical spine lordosis. Neurologic examination showed downbeat nystagmus, bulbar cranial nerve impairment, bilateral corticospinal tract signs, ataxia, and weakness and sensory loss in the hands. 

Tuberous sclerosis (688 KB)
15 years old female patient presented clinically with mental subnormality and Lennox Gastaut syndrome. The patient’s mother gave a history that when the patient was few months of age she had attacks suggestive of west syndrome.

Congenital syringomyelia and type I Chiari malformation (712 KB)
A 30 years old female patient presented clinically with gradual progressive atrophy of the small muscles of the both hands, Bilateral C5,C6 segmental hypoalgesia.

Amyloid angiopathy with multiple intracerebral lobar hematomas (464 KB)
A 65 years old female patient presented clinically with left sided hemiplegia of 10 days duration. The patient also gave a previous history of right sided hemiplegia of 8 months duration. The patient was normotensive when admitted with negative history of diabetes mellitus and other vascular risk factors.

Neuro-Behcet (298 KB)
40 Years old male patient presented clinically with right sided ataxic hemiparesis, of acute onset and regressive course. Oral and genital ulcerations were discovered during clinical examination.

Neuro-Behcet (357 KB)
30 Years old male patient presented clinically with bilateral pyramidal tract signs, pseudo-bulbar palsy, with oro-genital ulcerations. The patient also gave a history of nonspecific relapsing headache. Examination of sensation did not show any abnormality.

Multiple sclerosis (1066 KB)
A 40 Years old female patient, known to be suffering from multiple sclerosis, was presented clinically with painful diminution of vision in the right aye and mild weakness of the left upper limb.

Hemimegalencephaly (564 KB)
A 6 months old male patient presented with macrocephaly, west syndrome, right sided hemiplegia, and severe developmental delay.

Cerebral sinus thrombosis with congestive encephalopathy (879 KB)
A 40 years old female patient presented with headache, fits, and disturbed level of consciousness.

Cystic ependymoma of the conus medullaris (177 KB)
35 years old male patient presented clinically with progressive lower limb weakness and impotence of 3 years duration, disturbance of micturation with few drops of urine passing without the patient control was a prominent symptom.

Spinal ependymoma (189 KB)
40 years old male patient presented clinically with gradual progressive paraplegia and with a high dorsal sensory level.

Diffuse low grade mixed astrocytoma (grade II-III) (249 KB)
36 years old male patient presented clinically with a history of a single grand mal fit that occurred 2 days before clinical presentation. Past history was negative and clinical examination (both neurological and non-neurological) showed no abnormalities.

Brain stem juvenile pilocytic astrocytoma (460 KB)
15 years old male patient presented with symptoms of nausea, vomiting, and ataxia, with evidence of torticollis, papilledema, nystagmus, and palsies of the sixth and seventh cranial nerves at physical examination. Long-tract signs were conspicuously absent.

Dural spinal arteriovenous fistula (101 KB)
A 76-year-old male presented with left-sided weakness and sudden, progressive onset of bilateral lower extremity paraplegia. MRI showed a spinal dural arteriovenous fistula. Further evaluation of the AVM was requested.

Fusiform aneurysm of the vertebrobasilar system with mural thrombosis (570 KB)
A 60 years old male patient presented clinically with a clinical picture simulating the cerebellopontine angle syndrome with 7th, 5th, bulbar cranial nerve manifestations, cerebellar deficits and tinnitus in the right ear. Symptoms are gradual and progressive. The patient is hypertensive, with evidence of concentric left ventricular hypertrophy and type IV hyperlipidemia. The patient was not diabetic..

Subdural empyema (357 KB)
26 years old male patient presented clinically with a grand male fit, confusion, fever, headache, and nausea. Examination showed bilateral papilledema and left sided extensor planter response. The patient gave a history of nasal sinusitis two weeks before clinical presentation.

Hypoparathyroidism (385 KB)
A 33 years old female patient presented clinically with a grand male fit. The patient gave a history of thyroidectomy for the treatment of graves disease (hyperthyroidism)

Acute disseminated encephalomyelitis (412 KB)
A 18 years old female patient presented clinically with disturbed level of consciousness, recurrent grand mal fits, bilateral optic neuritis and meningeal irritation signs. The patient gradually improved during hospital stay and was discharged two weeks following admission after almost full recovery.