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Emory Radiology COTD #154

Hx: Gait problem & imbalance, young patient.

Learned something new myself with this case!!

NO SPOILERS!!! Give answers w/ GIFs ONLY or submit to bit.ly/EmoryRadCOTD

Answer in 24hrs

#Neuro #Neurorad #FOAMrad #FOAMed #Erad #radres #EmoryRadCOTD ImageImageImage
Answer: JC virus Granule Cell Neuronopathy

This pt had HIV. I didn't remember (or ever learn???) a differential for the "Hot Crossed Bun" sign. Always thought it was multiple system atrophy. #EmoryRadCOTD ImageImageImageImage
There is variant of JC virus that will attack the granule cells in the cerebellum causing a lot of the same symptoms. Here we demonstrate the need for good clinical history & a f%^&* smart neurologist. We see a plethora of PML, IRIS, HIV encephalopathy but this is new one for me
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