Teaching Video NeuroImages: The Stransky sign: A forgotten clinical sign

A forgotten clinical sign making a comeback.

We report a case of Staphylococcus aureus infective endocarditis in a patient presenting with fever and rare cutaneous manifestations of Osler Nodes and Janeway Lesions. There had not been any distinct risk factors. His echocardiography subsequently revealed vegetation at the anterior mitral valve leaflet. As Staphylococcus aureus infective endocarditis is of utmost significance in morbidity an...

Scalp vein sign: a forgotten clinical clue?

Mahadevan S, et al. BMJ Case Rep 2017. doi:10.1136/bcr-2017-220259 DESCRIPTION A 72-year-old man presented for general health check. He was asymptomatic except for hard of hearing and uses hearing aid for the last 4 years. Clinical examination revealed very prominent tortuous superficial temporal veins bilaterally, more on the left side (figure 1) with no bruit and a warm non-tender skull on pa...

Teaching neuroimages: MRI "target sign" and neurofibromatosis type 1.

A 9-year-old girl presented with a firm occipital swelling. She had multiple café-au-lait lesions without other clinical features or family history of neurofibromatosis type 1 (NF1). MRI showed subcutaneous soft tissue mass in the left occipitotemporal region with “target sign” suggestive of plexiform neurofibroma (figure 1). There were supra and infratentorial T2-weighted hyperintense lesions,...

Teaching NeuroImages: Spontaneous spinal epidural hematoma with spot sign positivity.

Teaching video neuroimages: lid lag sign and diplopia in paramyotonia congenita.

Clinical bedside tests to provoke myotonia, such as eyelid closure, handgrip, and percussion myotonia, help to diagnose and differentiate myotonic disorders and prevent delayed genetic confirmation. Sodium channelopathies present with predominantly myotonia of the ocular muscles. In these cases, testing for myotonia of the upper eyelid and extraocular muscles could be of decisive diagnostic val...