What do you do now

This patient has vascular dementia due to chronic microvascular disease. This entity, described originally by Otto Binswanger, a German pathologist, is characterized pathologically by multiple lacunar infarcts and confluent areas of soft, puckered, and granular tissue in the cerebral and cerebellar white matter. The white matter lesions are patchy and predominantly affect the periventricular white matter, especially anteriorly and close to the surface of the ventricles. The volume of white...

Arterial Dolichoectasia with Pontine Infarction

A 75-year-old man presented to an emergency department at noon reporting right-sided hemiparesis and dysarthria. One week before, he had a transient episode of right face, arm, and leg weakness, and dysarthria lasting thirty minutes with complete resolution. On the day of presentation, he awoke at 7 AM with similar symptoms but they persisted. For about a year he had had daily, brief, left-sided lancinating facial pains that were excruciating. This facial pain was triggered and exacerbated by...