Prevention strategies for COVID-19 transmission are at the forefront of healthcare paradigms worldwide, the main emphasis of which is vaccination. We present an interesting case of a 37-year-old man who, 3 weeks following his first dose of the chimpanzee adenovirus-vectored COVID-19 vaccine, ChAdOx1, presented to hospital with a rapidly progressive ascending muscle weakness and back pain in the absence of any other triggers. He also had a negative COVID-19 swab during admission. A diagnosis of Guillain-Barre syndrome was confirmed by correlating the clinical features with cerebrospinal fluid analysis, nerve conduction studies and MRI of the brain and whole spine. The patient received treatment with 5 days of intravenous immunoglobulin and did not require any respiratory support. He was also regularly reviewed by a multidisciplinary team consisting of neurologists, speech and language therapists, and physiotherapists and is on the course to a recovery.

The skull base is the major bony and soft tissue interface for the intracranial and extracranial compartments. Its anatomy is complex, containing multiple traversing foramina that act as conduits for various neurovascular structures. The optimum imaging modality depends on the specific diagnostic question and area of interest; both CT and MR have complementary roles. This article focuses on the applied compartmental anatomy of the skull base and specific imaging protocols, and discusses the range of pathologies that neurologists will encounter.

Malformations in either the inner ear, vestibulocochlear nerve (VIIIth) or auditory cortex of the brain can lead to congenital sensorineural hearing loss (SNHL). In most cases the underlying disorders involve the membranous labyrinth at a microscopic level and therefore radiological examinations are entirely normal. In a significant proportion however (up to 20%), there are abnormalities visualized in the inner ear and/or the VIIIth nerve; the type of abnormality is relevant for the surgical planning of a cochlear implant. Imaging and the accurate radiological identification of the affected inner ear structures therefore plays an integral role in the clinical evaluation of sensorineural hearing loss. In this pictorial review, we describe the main malformations of the inner ear in view of recent classifications and briefly explore the surgical implications.

Aim To identify clinical and radiological predictors of long‐term motor outcome after childhood‐onset arterial ischemic stroke (AIS) in the middle cerebral artery (MCA) territory. Method Medical records of 69 children (36 females, 33 males; median age at index AIS 3y 3mo, range: 1mo–16y) who presented to Great Ormond Street Hospital with first AIS in the MCA territory were reviewed retrospectively. Cases were categorized using the Childhood AIS Standardized Classification and Diagnostic Evaluation (CASCADE). Magnetic resonance imaging (MRI) and angiography were evaluated. An Alberta Stroke Program Early Computed Tomography Score (ASPECTS) was calculated on MRI. The Recurrence and Recovery Questionnaire assessed motor outcome and was dichotomized into good/poor. Results Eventual motor outcome was good in 49 children and poor in 20. There were no acute radiological predictors of eventual motor outcome. At follow‐up, CASCADE 3A (i.e. moyamoya) and Wallerian degeneration were significantly associated with poor motor outcome. In the multivariate analysis, younger age and CASCADE 3A predicted poor motor outcome. Interpretation In the context of recommendations regarding unproven and potentially high‐risk hyperacute therapies for childhood AIS, prediction of outcome could usefully contribute to risk/benefit analysis. Unfortunately, paradigms used in adults, such as ASPECTS, are not useful in children in the acute/early subacute phase of AIS. Adult paradigms, such as the Alberta Stroke Program Early Computed Tomography Score system, are not useful for predicting outcome in children. Younger children tend to have a poorer long‐term prognosis than older children. Moyamoya is associated with poor prognosis.

Gastrointestinal involvement is the most common visceral organ manifestation in systemic sclerosis. Symptoms from the gastrointestinal tract are very frequent among scleroderma patients and in many cases present a therapeutic challenge. However, gastrointestinal involvement may also be asymptomatic, presenting with complications later in the disease course. Early recognition of gastrointestinal scleroderma is therefore important both for symptomatic control and prevention of complications. Gastrointestinal imaging alongside clinical assessment forms the mainstay of diagnosis. Radiological investigations, traditionally plain radiographs and barium studies, with the more recent advances in computed tomography, magnetic resonance imaging and ultrasound, provide means for accurate evaluation of visceral organ involvement and more effective patient care. Awareness of the characteristic images is important not only for radiologists but also for the treating physicians and gastroenterologists.