Profile picture
, 5 tweets, 6 min read
My Authors
Read all threads
Wetread Case 31

Hx: altered mental status, weakness

Venturing into the Neuro realm 😮 CT pending 🤔

Feel free to answer with professionally appropriate gif responses only. No spoilers. wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #neurorad
CT finally complete

Does this help? Could you have made the diagnosis on the X-ray?

Hint: it may be long standing 😁

#WetreadCow #FOAMrad #FOAMed #radres #errad #neurorad
Answer: Dyke-Davidoff-Masson Syndrome (DDMS)

Early infection/infarction/insult to one of the cerebral hemispheres -> hemi-cerebral atrophy + homolateral hypertrophy of the skull and sinuses (to fill the space)
CT shows large area of encephalomalacia of the R MCA distribution + R calvarial thickening and hyperpneumatization of the frontal sinuses

Bony findings are apparent on the X-ray, just a little more difficult to appreciate (in fact originally described on plain films I believe)
Clinically patients are young presenting with hemiparesis (contralateral of course), seizures and intellectual disability

Did I miss anything @RyanBPetersonMD or @JudyGadde?

#FOAMrad #FOAMed #radres #errad #neurorad
Missing some Tweet in this thread? You can try to force a refresh.

Enjoying this thread?

Keep Current with Ryan Christie

Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

Twitter may remove this content at anytime, convert it as a PDF, save and print for later use!

Try unrolling a thread yourself!

how to unroll video

1) Follow Thread Reader App on Twitter so you can easily mention us!

2) Go to a Twitter thread (series of Tweets by the same owner) and mention us with a keyword "unroll" @threadreaderapp unroll

You can practice here first or read more on our help page!

Related hashtags

#WetreadCow #FOAMrad #FOAMed #radres #errad #neurorad

More from @RyanChristieMD see all

Profile picture
Ryan Christie
@RyanChristieMD
Wetread Case 32

Hx: Cough, shortness of breath, fever 😡😡 (yep, I did 😁)

Any pertinent hx questions? 🤔

Feel free to answer with professionally appropriate gif responses only. No spoilers. wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #chestrad
Would it help to know that the pt is immunosuppressed?

and NO it's NOT COVID-19! 😁

@RadioGyan @AdamSingerMD @xyzabrz @lala_layla_1
Answer: Kaposi’s Sarcoma

KS is a low-mid grade mesenchymal tumor that involves blood/lymphatic vessels of the skin, lymph nodes, lungs, GI tract, etc.

Not considered a true “sarcoma”

Believed related to human herpes virus type 8 (HHV8)

👏 to @DrAliya85 #chestrad #FOAMrad
Read 7 tweets
Profile picture
Ryan Christie
@RyanChristieMD
Wetread Case 30

Hx: foot pain

How about something, anything outside of the chest 😂

Feel free to answer with professionally appropriate gif responses only. No spoilers.
wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #mskrad #orthorad and no 🤔 or 🤭! 🤣
Answer: Intraosseous lipoma of the calcaneous

but I bet everyone knew that!

Classic appearance = a well circumscribed lytic lesion in the calcaneal body with central Ca++ (aka cockade sign)
Whats a cockade?

= a rosette - a knot of ribbon rolled into a badge.

So central density surrounded by well circumscribed low density area
Read 6 tweets

Related threads

Profile picture
Tom Folan, MD
@tomfolanmd
CASE REPORT

A female airline worker in her late fifties presented with a 3-day history of cough, fever, and altered mental status.

PCR (+) for SARS CoV2

CSF (-) for HSV 1/2, VZV, WNV, bacteria

NCCT head obtained

Arrows = hypoattenuation of the bilateral thalami

1/n #COVID19
B. CT Venogram (axial) is obtained to assess for patency of the bilateral internal cerebral veins (arrowheads)

The veins are patent & symmetric.

C. CT arteriogram (coronal) demonstrates patency of the posterior arterial circulation to include the basilar artery

#COVID19 2/n
Subsequently, MR Head is obtained:

A - Ax T2 FLAIR
B - Ax T2
E - Ax T2 FLAIR
F - Ax T2

All four images are remarkable for abnormal symmetric increased signal (bright spots) at bilateral medial temporal lobes & thalami

3/n

FLAIR = fluid-attenuation inversion recovery
Read 8 tweets
Profile picture
𝙻𝚎𝚎 𝚂𝚝𝚛𝚊𝚗𝚊𝚑𝚊𝚗 ⏳
@stranahan
POLL: What’s your mental state about COVID-19?

Please RT to get a larger sample size and feel free to comment.

Will discuss on @FaultLinesRadio

All responses include “No Answer” to see results without voting.

Are you worried that YOU may die from the COVID-19 virus?
Are you worried that a friend or loved one may die from the COVID-19 virus?
Are you worried YOU personally might suffer severe economic problems from the COVID-19 crisis?
Read 12 tweets
Profile picture
Antibiotic Steward🆔
@ABsteward
As Chloroquine & Hydroxychloroquine are being revitalized for the treatment of #COVID19 ,it is important to remember the severe toxicity associated with overdose & the proper management
References
inchem.org/documents/pims…

cdc.gov/mmwr/preview/m…

mdpoison.com/media/SOP/mdpo…
Thread/1
2/Chloroquine and Hydroxychloroquine have a very narrow therapeutic window a relatively small increase in the therapeutic dose is toxic. Toxicity with CQ and HCQ occurs shortly after overdose usually within one to three hours after ingestion. #COVID19
3/The symptoms of overdosage may include nausea, vomiting, headache, drowsiness, visual disturbances. The main toxic effects of chloroquine are related to its quinidine-like actions on the heart.
Read 9 tweets
Profile picture
Rabih Geha
@rabihmgeha
Teaching Rounds Day 3

Anemia - Part 1

Neighbors and Time Zones...

Join us #medtwitter & #medstudenttwitter
Claim:
It's nearly impossible to have an approach to anemia.

Yup, impossible.

It's as tough as having an approach to altered mental status?

Wait, what?

Wasn't that the VERY first @cpsovlers episode?
And...what about this schema??
Well, we lied.
Sort of.

That's an approach to ACUTE altered mental status.

Not just any old altered mental status....
Read 22 tweets
Profile picture
Pitt Internal Medicine Point of Care Ultrasound
@PittIMPOCUS
1/
 After a break for the new year, we are back with a case of #POCUS and abdominal distension.

59 y/o m with no medical history presenting with increasing abdominal girth and now altered mental status.

#IMPOCUS
2/
 HPI:
well until 3 months ago. Since then, progressive fatigue, nausea, mild diffuse itching without rash. Few weeks of early satiety, poor PO intake, and now increasing abdominal girth. Last BM 3 days ago. No vomiting. Weight unchanged over 3 months. No fevers/chills.
3/
 No home meds. 2-3 etoh drinks per day (none for a few wks). Unable to work due to symptoms. Past 1-2 days he has become confused and unable to ambulate.
Read 30 tweets
Profile picture
Filomena Rocha
@Filomen03258997
12. Assange a true HERO. The Siege & Injustice with Julian Assange

#WeAreAllJulianAssange #WeStandWithJulianAssange #FreeAssange #Assange #ProtectJulian #AssangeHERO #Injustice #HumanRights #freeSpeak #Liberty #Killers #WarCrimes #Liars #Democracy #TrueJournalists #Hipocrisy
Assange a true HERO 🥰👇🏼
1. Assange a true HERO. The Siege & Injustice with Julian Assange
🤨👇🏼
Read 89 tweets

Trending hashtags

#IMF #free #books #Wikileaks #MA #Iraq #IA #spacedlearning #urdupoetry #ConCon #Disability #HI #kindle #WeStandWithJulianAssange #TERREG #Tweetorial #nurses #amazon #NurseTwitter #IndiaDoesNotSupportCAA_NRC_NPR #Liars #PublicHealthNurses #RealityWinner #reading #WeAreAllJulianAssange

Embed code for your website

×
Follow Us on Twitter!

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just three indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3.00/month or $30.00/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!