Mark Hornyak, MDBoard Certified Neurosurgeon
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Educational Cases | Mark Hornyak, MD
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Cases
66 yo woman presents with leg greater than back pain Greater than 1 year duration Pain radiates down back of legs Numbness and tingling in calves No weakness, but reports falling Worsens with walking, better with rest Has had injections – limited benefit Has tried PT Ibuprofen helps Smokes ½ ppd; cutting down
View Case →67 year old man with history of cancer in his neck Routine CT of neck shows air inside his cranium (pneumocephalus).
View Case68 year-old man with progressive right hand pain, sensation loss, and weakness after successful cervical spine decompression
View CaseMicrovascular decompression for trigeminal neuralgia
View Case66 yo woman presents with leg greater than back pain Greater than 1 year duration Pain radiates down back of legs Numbness and tingling in calves No weakness, but reports falling Worsens with walking, better with rest Has had injections – limited benefit Has tried PT Ibuprofen helps Smokes ½ ppd; cutting down
View Case53 year old man presents with mid-lower back pain radiating to the left side of the lower chest and flank Severe after minor fall 2 weeks prior Mild back pain for about 4 months No significant prior medical history
View Case71 yo woman presents with 10 months of progressive weakness of arms and legs. Started with difficulty walking and has progressed to the point that she needs significant assistance to walk. She also reports difficulty with voiding. Examination reveals severe left-sided weakness most pronounced in left hand and hip muscles. She is hyper-reflexic.
View Case57 year-old presents with primary complaint of pain in his left gluteal region (buttocks) that radiates down to the back of his left thigh.
View CaseThis is a 70 year old male presents to ER after seizure. He has no history of seizure. The seizure occurred at dinner table. He had generalized shaking with loss of consciousness, witnessed by wife. The patient is without memory of the event. He complains of headache. He has no history of trauma. The patient has history of cardiac stents placed 3 years prior and takes aspirin, 81mg daily, and clopidogrel (Plavix) 75 mg daily.
View Case66 year-old woman presents with severe back pain. She has known history of breast cancer with spread to multiple bones. Back pain started 8 weeks prior without specific traumatic event. No neurologic complaint
View Case65 year-old man presents to ER after multiple falls. Describes progressive hand weakness and loss of dexterity along with difficulty walking resulting in multiple falls recently
View Case63 year-old woman presents with headache
View Case39 year-old woman presents with neck and shoulder pain radiating into her arms
View Case28 year old woman presents with complaint of right-sided hearing loss and sense of fullness within her right ear Exam with conductive hearing loss in right ear
View Case69 year old man with known history of renal cell carcinoma presents with cognitive decline and neck mass. Memory issues were attributed to chemotherapy. Also was having new headaches. Neck mass was due to an infection. Neurologic examination was relatively unremarkable.
View Case52 year old woman presenting to ER with new onset seizure. Patient & husband report being in good health until while seated in passenger seat of car, she had brief loss of consciousness with stiffening of right arm and body. Episode lasted about 2 minutes. EMS was called.
View Case27 yo man presenting with low back pain for five years. Radiates to posterior Left thigh Worse with flexion and extension; better w rest No numbness, tingling, weakness. Failed conservative care.
View Case48 year-old woman presenting with back and right leg pain Pain worsening despite conservative management Back and leg both 9/10 Leg pain goes to bottom of foot Has numbness of her foot on exam and some weakness of her ankle.
View Case64 year-old man presenting with headache and visual changes Headache for about 2 weeks getting stronger Seeing flashing lights and losing sight in the left side of his vision
View Case69 yo man presents with severe right ankle weakness (foot drop). He has bilateral foot numbness and moderate back pain radiating into his legs. Neurodiagnostic testing confirms L5 radiculopathy.
View Case20 year-old man presenting with headache Pressure in back of head When lifting weights, coughing, laughing Over 1 year, and getting worse Neurologic exam is unremarkable
View Case61 year old man undergoes unrelated surgical procedure. Upon waking from surgery reports new pain, numbness, tingling in his forearms and hands and weakness of his legs. No prior history of arm problems No neck pain Neuro exam with sensory loss in medial hands and radial forearm into axilla Proximal leg weakness Urgent MRI c-spine obtained
View CaseCavernous malformation. 24 year old woman presents to ER 2 years prior with first time seizure
View CaseC1-2 instability with rheumatic pannus 75 year-old woman with history of rheumatoid arthritis presents to office with several years of progressive neck pain. Also reports 3 months of numbness in her hands; denies weakness but reports apraxia
View Case65 yo woman presents to office with complaint of mid-back pain, progressive over several weeks Numbness in her toes for about 2 weeks She also complains of difficulty walking; feels off balance, but not dizzy On exam she has mild increased deep tendon reflexes.
View CaseThis is a 48 year old male with many years of hearing loss in the right ear.
View Case85 year old man presents with shock-like sensations shooting into his arms and hands Increasing numbness in hands One month of hand and arm weakness, getting worse rapidly Off balance walking Can’t use his hands for fine motor tasks like shaving, buttoning clothes etc.
View CaseInformation on this site should not be relied upon to make a medical diagnosis or determine treatment for a medical condition. Case examples are educational and de-identified. They do not represent expected outcomes for any individual patient. The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice.
