🧵For those of you using @viz_ai CT brain perfusion automated software for #stroke, here's a tip to avoid the pitfall of under-calling perfusion defect. This educational tip was helpful to our teams.
1) Example Case. 60yo F with acute right hemiplegia, LKN 12 hours ago, NIHSS 10. Noncontrast CT brain is negative. @viz_ai CTA autodetection goes off to alert for LVO and you can see left M1 occlusion below.
2) @viz_ai CTP software reports CBF 0cc/Tmax >6sec =6 cc indicating small penumbra (green). This CTP does not make sense with known LVO and clinical deficits. Something is not right. So what now?
1) @realDonaldTrump likely was infected with #COVID19 at the @WhiteHouse superspreader event for Amy Coney Barrett, based upon the timeline of events and what we know about COVID transmission
First, reviewing the evidence on #COVID19 transmission...
2) The average incubation of #COVID19 is ~ 5 days (median 5.1, mean 5.5). Fewer than 2.5% of those infected show symptoms within 2.2 days of exposure, and symptom onset will occur within 11.5 days for 97.5% of those infected acpjournals.org/doi/10.7326/M2…
3) Timeline of events:
- Sat 9/26 @WhiteHouse Superspreader event (180 people, no mandatory masking, lack of social distancing precautions)
- Tues 9/26 Debates (Trump party arrives late and skips testing by Cleveland Clinic)
- Thurs 10/1 Trump tweets late evening he has#COVID19
A #stroke#tweetorial. Inferior division MCA infarct often gets mistaken for PCA territory. Sometimes it can be quite difficult to distinguish MCA vs PCA territory infarcts (especially near the borderzone). #neurotwitter#medtwitter#medstudenttwitter
1/ Reminder of topography: MCA (yellow) and PCA (green) territory. Inferior division MCA (near the borderzone of PCA) involves the occipital lobe
3/ This is an example of a patchy MCA territory infarct. Note that the inferior division MCA affects the partieto-occipital lobe (except for the very medial portion of the occipital lobe, which we already stated is PCA). Red line indicates the borderzone between MCA/PCA