Pearls & Oy-sters: Vascular EDS presenting with acute proptosis: Always revisit the history.

Pearls & Oy-sters: polycythemia vera presenting with ischemic strokes in multiple arterial territories.

Pearls & oy-sters: cerebral venous air embolism after central catheter removal: too much air can kill.

Pearls & Oy-sters: cough headache secondary to Chiari malformation type I.

Pearls & Oy-sters: Spinocerebellar ataxia type 3 presenting with cervical dystonia without ataxia.

1. There is marked heterogeneity in the clinical features of spinocerebellar ataxia type 3 (SCA3). 2. Similar to pure ataxia, pure focal dystonia (torticollis) can be the only presenting symptom of SCA3. 3. High level of vigilance to obtaining family history needs to be maintained in susceptible ethnic backgrounds. 4. Genetic testing should be pursued early in such a group despite atypical pres...

Pearls & oy-sters: hyperdense or pseudohyperdense MCA sign: a Damocles sword?

• The presence of a true hyperdense sign can be confirmed by measuring attenuation value as compared to the normal-appearing contralateral side. • Mimics of a hyperdense sign (i.e., a pseudohyperdense sign) include vascular calcification, raised hematocrit, and intravenous contrast medium. • Careful attention should also be paid to the surrounding brain parenchyma to assess for hypodensity or a...