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More from @teachplaygrub

Lea Alhilali, MD

@teachplaygrub

Jan 31

1/Can’t remember what to look for on scans for memory loss?

New Alzheimer’s treatments are changing these scans!

Read on for the latest @theAJNR SCANtastic on imaging in AD:

… ajnr.org/content/early/

2/Current hypothesis in Alzheimer’s disease (AD) is that accumulation of amyloid beta (AB) protein result sin inflammation & neuronal death

Thus, new treatments in AD are focused on anti-AB antibodies that remove this protein in AD patients.

3/However, AB protein is also deposited in vessel walls in AD pts—just like in cerebral amyloid
angiopathy

So removing it from vessel walls increases vascular permeability, leading to edema & hemorrhage

Think of it like how a baby gets mad when you take its candy away!

Read 15 tweets

Lea Alhilali, MD

@teachplaygrub

Jan 31

1/Can’t remember what to look for on scans for memory loss?

New Alzheimer’s treatments are changing the way we look at these scans!

Read on to get up to date w/the latest @theAJNR SCANtastic on imaging for Alzheimer’s Disease:

ajnr.org/content/early/…

@TheAJNR 2/Current hypothesis in Alzheimer’s disease (AD) is that accumulation of amyloid beta (AB) protein result sin inflammation & neuronal death

Thus, new treatments in AD are focused on anti-AB antibodies that remove this protein in AD patients.

@TheAJNR 3/However, AB protein is also deposited in vessel walls in AD pts—just like in cerebral amyloid angiopathy

So removing it from vessel walls increases vascular permeability, leading to edema & hemorrhage

Think of it like how a baby gets mad when you take its candy away!

Read 15 tweets

Lea Alhilali, MD

@teachplaygrub

Dec 23, 2024

1/Does trying to figure out cochlear anatomy cause your head to spiral?

Hungry for some help?

Here’s a thread to help you untwist cochlear CT anatomy w/food analogies!

2/On axial temporal bone CT, you cannot see the whole cochlea at once. So let’s start at the bottom.

The first thing you come to is the basal turn of the cochlea (makes sense, basal=bottom). On axial images, it looks like a banana. I remember both Basal and Banana start w/B.

3/As you move up to the next slice, you start to see the upper turns of the cochlea coming in above the basal turn. They look like a stack of pancakes.

Pancakes are the heart of any breakfast, so they are at the heart or middle of the cochlea on imaging.

Read 9 tweets

Lea Alhilali, MD

@teachplaygrub

Dec 19, 2024

1/Talk about dangerous liaisons!

Abnormal brain vascular connections like a dural arteriovenous fistula (dural AVF) can be dangerous!

This month’s @theAJNR SCANtastic thread is here to you some durable knowledge about dural AVFs!

ajnr.org/content/45/12/…

2/Dural sinuses sit inside dural leaflets.

Arteries that feed the dura also feed the walls of sinuses, like vasa vasorum.

Arteries in the walls of veins are a natural connection between the veins and arteries—but these connections are usually closed in normal pts.

3/Whether these connections are open depends on pressure.

Like a hose w/a hole in it, at normal pressures, abnormal connections are not open.

But if pressure is increased w/thrombosis or stenosis, the connections open, like high pressure water squirting out through a hole.

Read 18 tweets

Lea Alhilali, MD

@teachplaygrub

Dec 6, 2024

1/Time to FESS up! Do you understand functional endoscopic sinus surgery (FESS)?

If you read sinus CTs, you better know what the surgeon is doing or you won’t know what you’re doing!

Here’s a thread to make sure you always make the important findings!

2/The first step is to insert the endoscope into the nasal cavity.

The first two structures encountered are the nasal septum and the inferior turbinate.

3/So on every sinus CT you read, the first question is whether there is enough room to insert the scope.

Will it go in smoothly or will it be a tight fit?

Read 19 tweets

Lea Alhilali, MD

@teachplaygrub

Dec 2, 2024

1/Ready for a throw down?

MMA fights get a lot of attention, but MMA (middle meningeal art) & dural blood supply doesn’t get the attention it deserves.

A thread on dural vascular anatomy!

2/Everyone knows about the blood supply to the brain.

Circle of Willis anatomy is king and loved by everyone, while the vascular anatomy of the blood supply to the dura is the poor, wicked step child of vascular anatomy that is often forgotten

3/But dural vascular anatomy & supply are important, especially now that MMA embolizations are commonly for chronic recurrent subdurals.

It also important for understanding dural arteriovenous fistulas as well.

Read 17 tweets

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