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Cogan Syndrome — SCE Neurology MCQ

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HardCNS InfectionsCogan SyndromeSCE Neurology

A 58-year-old has progressive deafness, gait ataxia and a hemosiderin rim over the posterior fossa and cord. MRI also shows a long ventral spinal CSF collection years after cervical disc surgery. Which strategy best targets the cause of deterioration?

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Correct answer: B — Dynamic CT or digital-subtraction myelography followed by targeted repair of the dural leak

Explanation lettering: B = shown as A · D = shown as B · A = shown as D

D is correct: infratentorial superficial siderosis commonly reflects chronic bleeding related to a spinal dural defect or CSF collection; dynamic myelography localises a rapid leak or fistula so targeted patching or surgery can stop the source. A may alter iron burden but does not correct ongoing bleeding. B can worsen low-pressure pathology. C does not repair the defect. E treats the wrong mechanism. Long-standing untreated leaks can cause irreversible siderosis, so source control is the learning priority.

Reference: Spontaneous intracranial hypotension: https://pn.bmj.com/content/24/2/98