Board Review 1 – Case 4

Neuroradiology board review. This lecture is geared towards the ABR core exam for residents, but it would be useful for review for the ABR certifying exam or certificate of added qualification (CAQ) exam for neuroradiology.

More description and the answer (spoiler!) are seen below the video.

In this case, there are bilateral basal ganglia and cortical FLAIR hyperintensities. Thalamic abnormalities involve the pulvinar nucleus and make an L-shaped abnormality known as the “hockey stick sign”.

The diagnosis is: creutzfeldt-jakob disease, or CJD.

CJD is a prion disease characterized by rapidly progressive dementia. The vast majority of cases are spontaneous, although some can be acquired through exposure to prions in meat.