Board Review 1 – Case 5

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.

This case has a patient with Parkinsonian symptoms and shows a nuclear medicine scan of the basal ganglia. This scan is an I131-ioflupane scan, or DaTscan. In this, the normal distribution is in both the caudate and putamen (like a comma). In parkinsonian syndromes, the putamen loses its normal signal and the image becomes more like a period.

The diagnosis is: parkinson’s disease

DaTscan can be useful in differentiating true parkinsonian syndromes (including MSA and PSP) from vascular or drug-induced parkisonism, among other causes. However, it cannot differentiate between PD, MSA, and PSP.