Clinically presenting acute/subacute ischemic stroke: differential diagnosis of the non-enhanced CT hypodensity by advanced neuroimaging.

Objectives: Patients presenting to the emergency room with an acute or subacute onset of focal neurological deficits are evaluated initially by non-contrast computed tomogram (CT) of the brain. This is primarily carried out to differentiate an ischemic from hemorrhagic stroke. However, other neurological conditions may have a similar clinical presentation as well as only hypodensities on CT scan, thus mimicking ischemic stroke.

Early onset dementia.

Dementia is characterized by a decline in cognitive faculties and occurrence of behavioral abnormalities which interfere with an individual's activities of daily living. Dementing disorders usually affect elderly individuals but may occur in individuals younger than 65 years (early-onset dementia or EOD). EOD is often misdiagnosed or its diagnosis is delayed due to the fact that it has a more varied differential diagnosis than late-onset dementia.

Wegener's granulomatosis with extension to the cavernous sinus.

Background: Wegener's granulomatosis (WG) is an uncommon inflammatory disease which rarely is reported to invade the cavernous sinus.

Objective: To report a case of cavernous sinus syndrome in a patient with longstanding pansinusitis who was found to have Wegener's granulomatosis.

Patient: A 59-year-old African American woman presented with a 10-day history of increasing nasal congestion with loss of taste and a 5-day history of increasing right frontal head pain with visual blurring of the right eye.

Differential diagnosis of multiple sclerosis.

There are a number of illnesses that can mimic multiple sclerosis (MS). This pretty much includes any pathological process that can reflect injury to the central nervous system either in a transient or progressive basis. Typically, MS presents itself in individuals in their teens up to their late 30s.

Neuroimaging findings in neurosyphilis.

We report two cases of neurosyphilis with atypical clinical presentations that were compounded by atypical neuroimaging findings. In the first case, MRI brain scan findings were felt to be compatible with mesial temporal sclerosis or herpes simplex encephalitis. The second patient presented with a clinical picture compatible with normal pressure hydrocephalus as well as some degree of ventricular enlargement and prominent periventricular white matter changes by MRI brain scan.