30th April 2024

A 49-year-old man presents with episodes of collapse. He describes unsteadiness on standing

A 49-year-old man presents with episodes of collapse. He describes unsteadiness on standing, with a single episode of becoming light-headed and fainting. He works as a business consultant and reports finding work increasingly difficult due to a lack of coordination and a resting tremor. He is on amlodipine for hypertension and takes sildenafil PRN. Examination shows rigidity in his right arm more than left, an ataxic gait and hyper-reflexia in his upper limbs. What is most likely to be seen on MRI?

Select the SINGLE most appropriate option from the list below. Select ONE option only.