Concluded Case

28/m c/o LBA,pain radiating to both LL for 3 months but now he has developed sudden onset weakness in both lower limbs.no h/o spinal injury.kindly comment on dx and Rx.please give ur valuable opinion

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Concluded answer

In view of low back ache and lower limb findings spinal imaging also should have been displayed. The patient is young male with multiplicity of the lesions 1)one involving the right cerebellum and the superior and middle cerebellar peduncle on the right side 2) and the other in the ? left frontal base. These lesions do not correlate with the complaints of low back ache which inevitable has to be a spinal pathology particularity with a history of radiation. Paraparesis could be attributed to the current mri but not radiating pain and low back ache. So if both have to be correlated, in a young male, then we need to consider a concomitant cranial and spinal pathology, the differentials for which could be 1) demyelinating diseases 2) vasculitic syndromes The list could go on

All Answers

In view of low back ache and lower limb findings spinal imaging also should have been displayed. The patient is young male with multiplicity of the lesions 1)one involving the right cerebellum and the superior and middle cerebellar peduncle on the right side 2) and the other in the ? left frontal base. These lesions do not correlate with the complaints of low back ache which inevitable has to be a spinal pathology particularity with a history of radiation. Paraparesis could be attributed to the current mri but not radiating pain and low back ache. So if both have to be correlated, in a young male, then we need to consider a concomitant cranial and spinal pathology, the differentials for which could be 1) demyelinating diseases 2) vasculitic syndromes The list could go on

Thank you doctor
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