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Posterior reversible encephalopathy syndrome (PRES) is a clinical-radiological syndrome that combines nonspecific neurological manifestations, sometimes severe (coma, status epilepticus), with typical brain imaging showing mostly bilateral, symmetrical abnormalities, predominantly affecting the white matter. Termed ''reversible,'' the norm is a return to the previous neurological state. However, this recovery is not always guaranteed, with potential neurological sequelae or even progression to death. PRES has multiple etiologies. The primary etiology associated with PRES is substance consumption. However, cases of PRES following cannabis consumption are rare. Here, we present the case of a 27-year-old man admitted for the management of a feverless altered state of consciousness, whose investigations eventually revealed PRES due to cannabis consumption.

A pituitary adenoma in the suprasellar region without involvement of the Sella turcica is uncommon, with few examples recorded in the literature. Imaging, particularly magnetic resonance imaging, is critical for diagnosis. Radiological features aid in distinguishing ectopic pituitary adenoma from other possible diagnoses, which include Rathke cleft cyst, suprasellar abscess, diabetes insipidus, suprasellar cellular infiltrate, and suprasellar tumors such as germinoma, craniopharyngioma, optic pathway glioma, suprasellar hemangioblastoma, and pituitary lymphoma. A 48-year-old lady with impaired visual acuity underwent an MRI, which revealed a suprasellar ectopic pituitary adenoma in contact with the pituitary stalk and optic chiasm.

Hydatid cyst, which is caused by the cestode echinococcus granulosus, is endemic in many countries around the world. Despite the frequency of this disease, no previous case of cerebral hydatid cyst with orbital extension has been reported, demonstrating the scarcity of this presentation. Cerebral hydatid cyst may be primary or secondary. Given to the nonspecifity of the clinical symptoms, cross sectional imaging, including CT and MRI, play an important role in the diagnosis by ruling out differential diagnoses, which are represented essentially by neoplastic and nonneoplastic intraparenchymal cysts as well as brain abscesses. Surgery remains the cornerstone treatment for cerebral and orbital hydatid cyst. In this article, we present the imaging findings of a patient with a primary cerebral hydatid cyst with orbital extension, and also the radiological features that could eliminate other differential diagnoses.

We report an uncommon case of primitive neuroectodermal tumor/ Ewing's sarcoma of the lumbar and sacral nerve plexus in a 17years old boy who presented with an intense pain in the lower back radiating to legs. Magnetic resonance imaging showed a soft tissue mass with thickening of lumbar and sacral spinal nerve roots (L5-S3 level), along with widening of the corresponding foramina. There was also posterior scalloping of L5/S1 vertebrae and invasion of the sacral bone. A Partial resection has been performed, and the ensuing histopathology confirmed the diagnosis of PNET/Ewing's sarcoma. MRI in conjunction with histopathology are the key to narrow down the differential diagnoses list. PNET of lumbosacral area remain scarce, and only few cases have been reported nowadays. Given to the aggressivity of these tumors, the prognosis is poor despite appropriate treatment.

Carotydinia, also called transient perivascular inflammation of the carotid artery (TIPIC) is a rare diagnostic entity related to an inflammation over the carotid bifurcation region. Despite the confusion about the definition of this term, neck pain remains the main symptom. Several articles revealed the relevance of imaging in the diagnosis of this disease. We report magnetic resonance and ultrasound images of a case with carotydinia, and also the elements that could eliminate differential diagnoses.

Twig-like or unfused middle cerebral artery (MCA) is a rare congenital vascular anomaly defined by the absence of the M1 segment. It can be found incidentally or can be revealed by cerebral ischemia or hemorrhage. Although rare, neuroradiologists should be familiar with such findings in order to differentiate them from differential diagnoses such as Moyamoya disease and steno-occlusive disorders of the MCA.We report a case of a twig-like MCA revealed by intracranial bleeding in an 84-year-old woman.

Craniocervical junction infections are considered a rare condition and can be associated with degradation of the odontoid ligaments and, the risk of a subsequent atlantoaxial subluxation or dislocation. Osteomyelitis at this level is often seen in immunocompromised patients with, intravenous drug use or infective endocarditis. Atlantoaxial subluxation associated with pharyngeal infection or its surrounding tissues is called Grisel's syndrome. We report the case of a 29-year-old man diagnosed with infectious cervico-occipital osteoarthritis complicated by atlantoaxial dislocation, abscesses located in the retropharyngeal space, and the prevertebral space as well as upper cervical epiduritis. Our purpose is to highlight the role of radiologists in diagnosing this rare yet deadly condition.

Tuberous sclerosis complex is a multisystem genetic disease with autosomal dominant inheritance, characterized by the development of benign tumors known as hamartomas that affect multiple organs. It is a condition with a wide phenotypic spectrum, and its clinical presentation varies over time within the same individual. Hence, the importance of early screening and rigorous monitoring of evolving clinical manifestations. Diagnosis can occur at any age. These tumors are generally benign, but their size and location can have a significant impact on the prognosis and, in some cases, even on life expectancy. Cardiac, neurological, and cutaneous manifestations are most common in childhood. The onset of early and severe epilepsy within the first year of life is associated with neurodevelopmental disorders that impact the quality of life for affected individuals and their families. We present a case of a 22-year-old female patient experiencing inaugural epileptic seizures in adulthood, with magnetic resonance imaging revealing subependymal hamartomas, cortical tubers and radial migration bands accompanied by polycystic kidney disease; the diagnosis of tuberous sclerosis complex was established based on the association of these lesions, which constitute major and minor criteria.

Hypertrophic olivary degeneration (HOD) is a rare form of transsynaptic degeneration. It is caused by a damage at the Guillain-Mollaret triangle (GMT), which is defined by three anatomical structures: the dentate nucleus, the red nucleus, and the inferior olivary nucleus (ION). Clinically, it may be revealed by palatal myoclonus. On MRI, it appears as a unilateral or bilateral enlargement of the inferior olivary nucleus which shows a high signal intensity on T2-weighted images, with sometimes a cerebellar atrophy. Here we report 2 cases of healthy patients which present hemorrhagic brainstem cavernomas, complicated later by the development of palatal myoclonus and cerebellar ataxia, with MRI features corresponding to an (HOD) secondary to a (GMT) cavernoma. The purpose is to explain the mechanism of (HOD) subsequent to lesion in (GMT), and to describe magnetic resonance imaging features.

Cervical spondylotic myelopathy, characterized by chronic spinal cord compression resulting from degenerative spine changes, manifests with a spectrum of neurological and pain symptoms. Despite the complexity of intramedullary spinal cord abnormalities, employing a systematic approach to differential diagnosis, considering factors such as lesion location, cord length, segment involvement, and enhancement pattern, can significantly aid in narrowing down the potential diagnoses, potentially avoiding invasive diagnostic procedures and guiding treatment decisions. This article presents two cases of cervical spondylotic myelopathy characterized by progressive weakness and paraesthesia, exhibiting progressive bilateral upper extremity numbness, tingling, and impaired gait, with cervical myelopathy evident on MRI displaying transverse pancake-like gadolinium enhancement.

Intracranial dermoid cysts are rare slow-growing cystic lesions. They are frequently extra-axial, intra-axial localization is very rare. These benign congenital ectodermal inclusions cysts have a rare risk of rupture. Ruptured dermoid cysts can manifest with headache, epilepsy seizure, cerebral infarction, meningitis, and hydrocephaly. Neuroimaging features are quite characteristic. We report a case of a 30-year-old male who presented to the emergency room with subacute-onset headaches. CT scan and MRI show a ruptured intracranial dermoid cyst.

Eagle syndrome is defined as a collection of symptoms affecting the cervical and cranial regions, resulting from an elongated styloid process or ossified stylohyoid ligament encroaching on surrounding structures and causing a variety of symptoms. Classically, Eagle syndrome presents as neck, throat, or ear pain. Carotid artery dissection is a rare complication of Eagle syndrome. We report the case of a 40-year-old man who presented with bilateral internal carotid artery dissection secondary to pathological elongation of the styloid processes.

Leukocoria is an aberration of the eyeball that interferes with normal reflection. It shows up as a white or gray pupillary reflex rather than the bright red or orange pupil of the other eye. Leukocoria can be brought on by a variety of ocular pathologies, with retinoblastoma being the most common. We present the case of a 17-month-old guy who had unilateral leukocoria and whose orbital MRI was ordered on the basis of retinoblastoma suspicion. The results, however, were more suggestive of Coats disease than retinoblastoma. Telangiectasia and exudate, which frequently afflict males’ unilateral eyes, are the hallmarks of Coats’ illness. Depending on the stage of the disease, there are differences in its severity, course, and outlook. It is crucial to get therapy and a diagnosis for retinal problems as soon as possible. Although uncommon, there are still many people who are not familiar with Coats’ disease. This paper aims to describe imaging findings in Coats' disease.

Schizencephaly, a rare congenital cerebral deformity that affects the cerebral mantle and is caused by both hereditary and acquired factors, is defined by a cleft that spans the entire cerebral hemisphere from the lateral ventricle to the cerebral cortex. Adult symptoms have only been described in a few cases in the literature. Hemiparesis, developmental delays, or seizures are manifestations of the clinical presentation, which is dependent on the size and location of the lesion. Neuroimaging investigations, particularly MRI, enable the diagnosis and rule out other causes. Usually discovered at birth, this entity begins to show up in the first several years. To prevent receiving the wrong treatment, the ailment must be correctly diagnosed. We report the observation of a 43-year-old patient with partial epileptic seizures but with an asymptomatic childhood, in relation to unilateral closed cleft schizencephaly associated with gray matter heterotopia. In this case, we highlight the importance of neuroimaging, in particular MRI on the diagnosis of this entity and to identify the associated anomalies.

Neurofibromatosis type 1 (NF1), formerly known as von Recklinghausen disease is an autosomal dominant disease with multisystem involvement. In the peripheral nervous system, it leads to the development of benign tumors from the tissue of the spinal or cranial nerve sheaths, known as “neurofibromas.” We report the case of a 40-year-old patient with spinal cord compression syndrome in whom spinal MRI revealed cervical, dorsal and lumbosacral neurofibromas revealing neurofibromatosis type 1.

Septo-optic dysplasia (SOD) is a rare malformation defined by septum pellucidum abnormalities and hypoplasia of the optic nerves and chiasm. It can be associated with cortical development malformations such as schizencephaly, which is then called septo-optic dysplasia plus. It usually manifests at birth, although it may not be diagnosed until childhood, or rarely, adolescence. We report the case of a 23 years old patient, with a history of epilepsy since early childhood never labeled, which was diagnosed with SOD-PLUS with brain MRI in our department.

Amyotrophic lateral sclerosis is a progressive neurodegenerative pathology. It involves both upper and lower motor neurons, leading to their degeneration. Lower motor neurons can be detected with an electromyogram, but the detection of upper motor neuron dysfunction may be more accurate using MRI. We present the case of a 64-year-old woman with amyotrophic lateral sclerosis, presenting the motor band sign and the bright tongue sign on MRI.

Posterior reversible encephalopathy syndrome (PRES) is an uncommon, but important, pathology affecting primarily the posterior cerebral circulation. Typical imaging features include vasogenic edema involving the bilateral occipital and parietal lobes. We report 4 cases of atypical PRES: The first one is a 59-year-old woman with a medical history of diabetes and hypertension who presented a consciousness disorder. MRI of this patient revealed signal abnormalities in the thalamus, the cerebellum, the brainstem and the corpus callosum with microbleeds and vascularization disorders. The second patient is a 41-year-old woman admitted for right hemiparesis and facial paralysis. Physical examination found a hypertension and the atypical imaging features on MRI were low ADC values with a pearl necklace appearance on ARM sequences. The third patient is a 32-year-old woman who undergone a surgery for an ectopic pregnancy and went in a coma for 8 days. Physical and biological parameters were normal. Diagnosis was delayed because of atypical signal abnormalities in caudal and lentiform nuclei that worsened on follow-up MRI, resulting in a dramatic evolution to bilateral cecity and psychosis. The last case is a 34-year-old woman with terminal renal failure hospitalized for spontaneously resolving tonic-clonic seizures. Biology showed high uremia and brain MRI revealed a gyriform enhancement at gadolinium injection with unilateral putamen lesion. The patient improved after blood purification. Knowledge of these atypical findings can help the radiologist make an accurate, timely diagnosis, and improve patient care.

Fahr's disease is a rare neurodegenerative disorder, identified by bilateral and symmetrical intracerebral calcifications of mainly the basal ganglia. Patients often present extrapyramidal or neuropsychological symptoms. Seizure is one of the rarest manifestations that can reveal Fahr disease. We present the case of a 47-year-old male patient who had Fahr disease revealed by an inaugural tonic-clonic seizure.

We report a case of a patient with no medical history, admitted for right exophthalmos. For whom imaging showed orbital masses without inflammatory signs pointing to a granulomatous origin. However, the histological and immunological workup revealed the diagnosis of Granulomatosis with polyangiitis.