Objective The aim of the study is to visually rate major forms of dementia using global cortical atrophy (GCA), medial temporal lobe atrophy (MTA), and Fazeka’s scales and Koedam’s score using magnetic resonance imaging (MRI). The purpose is to correlate the visual rating scales (VRS) with severity of dementia. Materials and Methods Thirty patients fulfilling DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) criteria for Alzheimer’s dementia (AD), vascular dementia (VaD), and frontotemporal dementia (FTD) underwent MRI brain. Cortical atrophy, medial temporal, and parietal lobe atrophy were assessed using GCA and MTA scales and Koedam’s score, respectively. White matter hyperintensities were assessed using Fazeka’s scale. Correlation between VRS and mini-mental state exam (MMSE) scores was done using Pearson correlation coefficient. Results 70% of patients had Grade 2 GCA. More patients with AD had higher MTA scores as compared with others with 57% of AD patients showing abnormal for age MTA scores. Fazeka’s scale was abnormal for age in 58.33% of VaD and 57% AD patients. Majority (75%) showing severe parietal atrophy (Grade 3 Koedam’s score) were AD patients. Disproportionate frontal lobe atrophy was seen in all four (100%) FTD patients. Significant negative correlation was seen between MMSE and GCA scores of all patients (p-value = 0.003) as well as between MTA and MMSE scores in AD patients (p-value = 0.00095). Conclusion Visual rating of MTA is a reliable method for detecting AD and correlates strongly with memory scores. Atrophy of specific regions is seen more commonly in some conditions, for instance, where MTA and parietal atrophy are specific for AD while asymmetric frontal lobe and temporal pole atrophy favor FTD.

Cysticercosis, caused by cysticercus cellulosae, the larval form of Taenia solium, is potentially a dangerous systemic disease with variable clinical manifestations. The disease most commonly involves subcutaneous and muscle tissues, followed by the eye and brain. Cysticercosis can be diagnosed by various radiologic means or by serology, both of which, however, are not definitive. Biopsy and histologic examination containing the cysticerci is the most definitive method of diagnosis. We report a case of cysticercosis in a 27-year-old male patient, who presented with a subcutaneous swelling in the back which was diagnosed on fine needle aspiration cytology (FNAC).

Meningitis and associated intracranial bleeding have been rarely reported in patients with steroid-resistant nephrotic syndrome. We present such a case with raised intracranial tension in a 13-year-old child and discuss the management issues. Prompt recognition and appropriate treatment of these complications can be life saving in a child with nephrotic syndrome.

Background: ASPECTS (Alberta Stroke Program Early CT Score) is a validated scoring system for assessment of early ischemic change (EIC) on CT head scans, which can be used to guide patient management and improve diagnostic accuracy. Detection of EIC can be challenging particularly for less experienced clinicians. e-ASPECTS software uses machine learning algorithms to support physicians in detecting EIC, which can be quantified using the ASPECTS score. Hypothesis: e-ASPECTS shortens time for CT scan assessment and improves agreement with reference standard ASPECTS when compared to blinded assessment. Methods: 26 clinicians (including 11 radiologists, 6 junior and 7 consultant stroke physicians, and 2 non-specialist physicians) independently scored 2560 ASPECTS regions from 64 patients for signs of EIC on non-contrast CT brain scans. These were acquired within 4.5 hours of stroke onset. A familiarization training set of 5 patients was used prior to scoring. Images were randomized to manual or software assistance. After two weeks images were rescored using the alternative method. Scorers were blinded to clinical symptoms. Reference standard scores were defined by an independent neuroradiologist with information on clinical symptoms, access to 24h follow-up, and with CT perfusion or MRI scans when available. Results: Mean NIHSS was 11. Mean time to score scans fell by 34% (45s, 2:12 to 1:27, mm:ss) using e-ASPECTS assistance. Rater agreement with ground truth was greatest in the radiologist cohort, but performance improved across all clinician categories using e-APSECTS assistance (radiology kappa: 0.26 to 0.38). Sensitivity to EIC improved by a factor of two across all clinician groups using e-ASPECTS assistance, and this was most marked for less experienced physicians. Conclusion: In acute ischemic stroke e-ASPECTS assisted analysis increased accuracy and reduced time for detection of EIC. Routine assistance of non-contrast CT interpretation has the potential to reduce treatment times and improve accuracy across clinicians and sites.