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Ectopic thymic tissue is an unusual finding that is generally asymptomatic. We present a case series of five pediatric patients with cervical ectopic thymuses. In two patients, the ectopic thymic tissue was symptomatic, and in three patients, it was an incidental finding. We highlight the need to include this anomaly in the differential diagnosis for a pediatric neck mass. We also propose observation, rather than surgical excision, as the treatment of choice for asymptomatic cervical ectopic thymus.

A 23-year-old man with a history of limited right ankle dorsiflexion presented to the MRI suite for a routine lumbar spine MRI. The patient denied history of prior spinal trauma or systemic symptoms. Aside from mild right ankle pain, physical and neurological examinations were unremarkable. Lumbar spine MRI revealed subdural fluid collections at T12-S1 levels (figure 1A, B). Follow-up enhanced brain MRI (not shown) and cervicothoracic spine MRI (not shown) in the same week were both unremarkable, with no evidence of intracranial hypotension or extra-arachnoid fluid collections. Two weeks later, CT myelogram (figure …

A 38-year-old man presented with 2 to 3 months of intermittent headaches. Aside from hypertension, the patient was in good health. Physical examination and laboratory values were unremarkable. Routine unenhanced head CT (figure 1A,B) and gadolinium enhanced brain MRI (figure 2A–D) revealed a right frontoparietal cystic mass measuring 6.0×3.9×5.0 cm with an enhancing mural nodule and minimal peritumoral oedema. Imaging findings were suggestive of a primary glial tumour. The patient underwent surgery and the mass was completely resected. Histopathology …

Accurate preoperative evaluation of language dominance is critical when evaluating potential patients for temporal lobe epilepsy surgery. Although most people have left-sided language dominance, a minority of patients have been described with either bilateral or right hemispheric dominance. We present a patient with right temporal lobe epilepsy who presented with bilateral and functionally independent Broca areas, as confirmed by Wada testing and functional magnetic resonance imaging.

Spontaneous dissection of the internal carotid artery is an increasingly recognized condition that is readily identifiable with magnetic resonance imaging and -angiography. Early recognition of this entity is essential for optimizing medical management and avoiding potential cerebral infarction. We present a case of dissection of the internal carotid artery that occurred during magnetic resonance imaging and describe the immediate imaging characteristics.

Posterior reversible encephalopathy syndrome (PRES), also known as reversible posterior leukoencephalopathy syndrome (RPLS), is most often associated with hypertensive emergencies and is characterized by seizures, mental status changes and visual disturbances. We report a case of a previously healthy young man who developed multiorgan failure and transient cortical blindness following ingestion of a performance-enhancing ephedra-based supplement. Neuroimaging findings confirmed the clinical suspicion of PRES. Radiographic abnormalities and neurologic dysfunction subsequently resolved with correction of his systolic blood pressure. This case emphasizes the need for prompt treatment and consideration of toxic ingestions in patients presenting with hypertension-related end-organ dysfunction.