Article Text
Neurological picture
An unusual “empty delta sign”
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A 34 year old man developed fever, right ear pain, and diffuse pulsatile headache 10 days prior to admission. Five days later he noticed difficulty in walking, instability, and intention tremor. Neurological examination showed a wide base gait, stance instability, slurred speech, bilateral horizontal nystagmus, intention tremor, four limb dysmetria, and dysdiadochokinesia. There were no signs of intracranial hypertension or cranial nerve dysfunction. Otoscopy revealed a hyperemic right tympanic membrane. Computerised tomography (CT) scan showed slow emptying of contrast in the left …