Progressive ascending myelopathy: atypical forms of multiple sclerosis or what else?

The spinal cord can be affected by multiple heterogeneous disorders often difficult to diagnose. We describe ten patients affected by a progressive ascending myelopathy with a poor prognosis. The patients, during the follow-up period, underwent neurological examinations, cerebrospinal fluid analysis, hematological, microbiological, auto-antibodies screening, brain and spinal cord magnetic resonance imaging (MRI) and electroneurophysiological study.

Primary central nervous system lymphoma: role of DWI in the differential diagnosis.

The case of a female patient admitted to the hospital for a syncopal episode characterized by mental confusion, retrograde amnesia, agnosia, lack of sphincter control and behavior disorders, is presented. Cranial CT showed a frontal bihemispheric lesion. MRI completed with DWI was then performed to better define the nature of the lesion and for an in-depth diagnostic study.

Unusual lesion of the thalamic pineal region: role of conventional MRI and DWI in the differential diagnosis.

The case of a 53-year-old female patient admitted to the Emergency department with symptoms from right third cranial nerve of acute onset, is presented. Cranial CT, performed in emergency, documented an intra-axial mass which required an in-depth diagnostic study with cranial MRI after contrast administration. Conventional MRI and DWI helped in correct lesion characterization and in the differential diagnosis with other brain disorders.

Multiple watershed cerebral infarcts.

The case of a 63-year-old female patient affected by arterial hypertension under home therapy, with disordered consciousness and confusion, is discussed. At the emergency department of another hospital she underwent cranial CT which showed mild swelling of right cerebral hemisphere. Based on the clinical suspicion of herpes simplex encephalitis compatible with a first MRI examination of the brain, the patient was admitted to the department of infectious disease of the polyclinic to confirm the diagnosis and plan the therapeutic approach.