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The Sub-Spider Meninges
A 55-year-old woman is brought to the ER by her husband. The husband states that his wife had a sudden severe occipital headache which is then followed by clouded consciousness. You examine the patient thoroughly and you consider subarachnoid hemorrhage. ...
 
Subarachnoid Bleed!
A 45-year-old female has been referred to your ER as a suspected case of subarachnoid hemorrhage. Your interns ask you few questions about this type of hemorrhagic stroke. With regard to non-traumatic subarachnoid hemorrhage (SAH), which one is the wrong statement
 
The SAH's Outlook!
The older sister of this 49-year-old man who has acute subarachnoid hemorrhage asks you about the outlook her brother has. You explain to her the prognosis of this type of hemorrhagic stroke and she understands. Regarding the prognosis of subarachnoid hemorrhage (SAH), choose the incorrect statement
 
Myelin 08
Though not pathognomonic, this cell is characteristically seen in which of the following processes
 
Upper extremity muscle function and innervation 04
During a needle EMG of the upper extremity, you notice a large number of fibrillations in the pronator teres muscle while the patient is at rest. From this, you deduce that the patient has a lesion. Of the following options, which lesion is most compatible with the EMG findings
 
Upper extremity muscle function and innervation 04
During a needle EMG of the upper extremity, you notice a large number of fibrillations in the pronator teres muscle while the patient is at rest. From this, you deduce that the patient has a lesion. Of the following options, which lesion is most compatible with the EMG findings
 
Loss of the Blanket!
You are investigating a young female with a suspected multiple sclerosis (MS), and CSF analysis is one of your lab tests. Your intern suggests looking for an elevated level of CSF myelin basic protein (MBP). How would you respond to him
 
A Stroke on the Head!
A 65-year-old man with long-standing hypertension and type II diabetes presents with left arm pyramidal weakness of grade 4 minus over the past 2 hours. Examination does not uncover any language or sensory problems. His non-contrast brain CT scan is unremarkable...
 
Toxicity and Characteristic Pathology 02
Courtesy of Dr. Mark Cohen A 25 year old woman in previously good health is found at home, comatose and with bright red skin.  After a few days in the ICU, the patient expires.  An autopsy is performed. The brain is shown in the image above. What was the cause of death
 
Upper extremity muscle function and innervation 03
During a needle EMG of the upper extremity, you notice a large number of fibrillations in the first dorsal interosseous muscle while the patient is at rest. From this, you deduce that the patient has a lesion. Of the following options, which lesion is most compatible with the EMG findings
 
Upper extremity muscle function and innervation 03
During a needle EMG of the upper extremity, you notice a large number of fibrillations in the first dorsal interosseous muscle while the patient is at rest. From this, you deduce that the patient has a lesion. Of the following options, which lesion is most compatible with the EMG findings
 
Upper extremity muscle function and innervation 02
During a needle EMG, you notice a large number of fibrillations in the abductor pollicis brevis muscle while the patient is at rest. From this, you deduce that the patient has a lesion. Of the following options, which lesion is most compatible with the EMG findings
 
Upper extremity muscle function and innervation 02
During a needle EMG, you notice a large number of fibrillations in the abductor pollicis brevis muscle while the patient is at rest. From this, you deduce that the patient has a lesion. Of the following options, which lesion is most compatible with the EMG findings
 
Stroke Etiology 02
What percentage of strokes are considered cryptogenic
 
Stroke etiology 01
Which of the following statements about stroke etiology is most accurate
 
Pediatric Epilepsy Syndromes 11
A 9 year-old girl presents to your office accompanied by her parents. The parents state that on 3 occasions over the past several months, the girl has come into their room in the early morning, drooling and having difficulty talking, with a slight facial droop...
 
Neuroanatomic correlates of stroke-related myocardial injury
Myocardial infarction after a stroke, occurring without any apparent primary cardiac cause:
 
Cranial Neuropathies 01
Which of the following is the most common cause of unilateral cranial nerve XII palsy
 
Hemorrhage after IV tPA for Acute Stroke
A 56 year-old man has the sudden onset of facial droop, left gaze deviation, right-sided weakness, and global aphasia. This is witnessed by his mistress, who accompanies him to the emergency department, where he arrives less than 20 minutes after the onset of symptoms...
 
Cerebrovascular Disease 02
A 45 year old male presents with a sudden onset of left upper extremity weakness and numbness. Past medical hisotry is significant for migraines. His exam reveals only the above described weakness. His father and paternal grandmother also had migraines...
 
Inborn Errors of Metabolism 03
A 15 year-old female presents with complaints of weakness and progressive difficulties with walking. Physical exam reveals hypotonia and absent patellar and achilles reflexes. An MRI is obtained, and is shown above.Of the following, which is the most likely diagnosis
 
Stroke Syndromes Imaging 01
One day after after the onset of this patient's stroke symptoms, the above FLAIR MRI image was taken. Of the following choices, which syndrome is most likely to be found in this patient
 
Cerebrovascular Anatomy 1
This image shows:
 
Comprehensive Neurological Workup
A 28-year old right-handed man with no prior medical history visits the opthalmologist for followup after refractive surgery for unilateral astigmatism the previous month. A normal left fundus is visualized, but an incidental finding is made of a small foul-smelling...
 
Tremor 01
A very old man is seen in clinic by his Neurologist. He complains of more than 2 years of worsening tremor. The tremor is worse in the right hand. It improves slightly when he uses the hand to perform a task. He has no cognitive symptoms. He drinks 5 40-oz beers every night...
 
Wallenberg Syndrome 1
A famous elderly, retired model presents to the E.R. She had no neurologic defecits prior to this morning, when she awoke to several new symptoms, the most concerning to her of which are changes in the way her face looks, as shown in the image above. She...
 
lacunar stroke syndromes
Which of the following statements regarding lacunar stroke syndromes is FALSE
 
Cortical Stroke Syndromes 01
A patient presents with a stroke. Physical exam reveals obvious blindness, but denies that he is blind. What is the name of this syndrome
 
Pathology in Ischemic Stroke 03
A patient presents with an acute ischemic stroke and dies 6 months later. Of the following choices, which is most likely to be seen on pathological examination of the brain at autopsy
 
Pathology in Ischemic Stroke 02
A patient presents with an acute ischemic stroke and dies 1 week later. Of the following choices, which is most likely to be seen on pathological examination of the brain at autopsy
 
Pathology in Ischemic Stroke 01
A patient presents with an acute ischemic stroke and dies 18 hours after onset of symptoms. Of the following choices, which is most likely to be seen on pathology
 
INO
What is the most common cause of bilateral internuclear ophthalmoplegia
 



User Forums and Comments



Lancet Neurology Podcasts
Lancet Neurology Podcasts Recent podcast: Strokes in children and more
 
Re: Useful Links Forum
The National Institute of Neurological Disorders and Stroke (NINDS) -
 
Welcome!
Welcome to FrontalCortex.com! This web site was started as a resource for neurology residents, medical students studying neurology, and medical personnel in the field of neurology. FrontalCortex.com has many useful resources. There is a section with downloadable software for your PDA...
 



Online Course Content



PCA stroke, medial surface of brain, labelled (image)

 
PCA stroke, medial surface of brain (image)

 
ACA infarct sagittal (image)

 
PICA stroke, whole brain photo (image)

 
Left MCA stroke, whole brain (image)

 
Alexia without agraphia resulting from ischemic stroke with arrow (image)

 
MRI DWI left ACA stroke (image)

 
CT left PCA stroke (image)

 
Right MCA stroke (image)

 
Alexia without agraphia resulting from ischemic stroke (image)

 
MRI Fluent Aphasia (image)

 
MRI acute right MCA stroke (image)

 
CT dense MCA (image)

 
Primitive Reflexes - The Rooting Reflex
ROOTING REFLEXClick Here to See the VideoTest:† This is a sensory reflex, which occurs when an infant responds to stimulation on around the mouth.† In the video, you can see the examiner stroke the baby on the perioral area.Normal response:† The infant will...
 
Images
A picture paints a thousand words.Sometimes, it's just very helpful to be able to show someone a picture of what you're talking about.† For example, this is what a glioblastoma multiforme looks like on MRI: †Or, here is a map of the Ohio river valley:††FrontalCortex...
 
Stroke Pie Chart (image)

 
Fungal Infections
Aspergillus species grow on decaying vegetation and grain products, and are ubiquitous in the environment. Infection typically occurs in immunocompromised, usually neurtropenic,† hosts. Aspergillus may also rarely produce brain abscesses and granulomas in individuals with a normal immune system...
 
Bacterial Infections
Meningitis means inflammation of the meninges, usually (but not necessarily) due to infection. Although inflammation may selectively involve the dura (pachymeningitis), it more commonly affects the pia and arachnoid membranes (leptomeningitis). Because the...
 
Vascular Disease 4: Other topics in vascular disease
Working from the outside in, intracranial hemorrhage may be epidural, subdural, subarachnoid, intraparechymal, or intraventricular in origin (though many do not remain localized to a single compartment). The term “hemorrhagic stroke” only applies...
 
Vascular Disease 1: Reaction to ischemic injury
There are different types of ischemic injury.† Ischemia can affect the entire brain, or just a particular vascular distribution.† It can be brief, as in a TIA, or it can endure.† The patterns of damage we see in gross and microscopic pathology reflect the focality and temporal course of the ischemia...
 
A few words about Bacterial Meningitis
Meningitis means inflammation of the meninges, usually (but not necessarily) due to infection. Although inflammation may selectively involve the dura (pachymeningitis), it more commonly affects the pia and arachnoid membranes (leptomeningitis). Because the...
 
PLEDs (image)

 
Recent middle cerebral artery infarct, whole mount coronal section through frontal lobe, labeled (image)

 
Cavitated MCA infarct, lateral surface of brain, labeled (image)

 
Pathology in Ischemic Stroke 03
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Pathology in Ischemic Stroke 02
126
 
Pathology in Ischemic Stroke 01
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For Comparison, MRI DWI - Acute Left PCA Infarct (image)

 
Anatomical Landmarks Labeled (image)

 



Gallery Images



Alexia without agraphia resultin

 
MRI ADC acute right MCA stroke

 
MRI DWI left ACA stroke

 
CT left PCA stroke

 
MRI DWI fluent aphasia

 
CT R MCA stroke

 
CT dense MCA

 
MRI Right MCA stroke DWI

 
MRI acute R MCA stroke

 
Recent middle cerebral artery in

 
Cavitated MCA infarct, lateral s

 
Dorsolateral Medullary Infarct,

 
Brain Pie Chart

 
Stroke Right PCA

 
Alexia without Agraphia 01