2/Coming from anterior, the first lobule is the lingula. It sticks out from the front of the vermis & is connected to the superior cerebellar peduncle. I remember this bc it has a very appropriate name—lingula—it looks like a tongue sticking out of the vermis to lick the SCP.
3/Moving clockwise, next is the central lobule. I remember this bc it is positioned exactly how a central lobule should be positioned, in the driver’s seat—where the front seat driver position would be if the vermis was a car—up front, looking out the windshield over the lingula
4/Next lobule over is the culmen. I remember this bc culmen sounds like culminate—which means to reach the highest altitude—and that’s what the culmen is—it is the highest point—the mountain peak of the vermis.
5/Next is the declive. This is easy to remember bc after reaching the peak of the culmen, what happens next? We have to go down or decline = declive. The declive is the lobule that starts to go down after the culmen—not unlike our current stock market 😬
6/After declive is the folium. I remember this bc it looks like a thin fern branch, or “foliage,”with a thin stem and just a thin layer of leaves
7/The tuber follows the folium. It is similar to the folium, except instead of being thin like a fern branch, it is much chunkier, with thicker nodules on it. Hence its name is easy to remember—tuber means potato, and this lobule has a fatter, rounder contour like a potato.
8/As we continue around, next is the pyramid. This one is easy to remember—it is triangular like a pyramid, and hence its name
9/Hanging down from the bottom of the vermis is the uvula. It is easy to remember how they named this one. It hangs down from the vermis just like your uvula hangs down from the roof of your mouth.
10/Last is the nodule. I remember this bc nodule sounds like nose--and it even looks like a nose—pointing out from the middle of the vermis the way the nose points out of the middle of your face.
11/”Ok,” you might say, “Now I can remember the names, but how can I remember the order?” I’ve got your back. The vermis is important for truncal balance, so my mnemonic is “Let’s Count the Cerebellar Design for Truncal Posture and Unsteadiness.”
12/So now you know how to remember all the lobules of the vermis and have a mneumonic to remember their order. May your knowledge continue to culminate and never declive!
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@TheAJNR 2/Perfusion imaging is based on one principle: When you inject CT or MR intravenous contrast, the contrast flows w/blood & so contrast can be a surrogate marker for blood.
This is key, b/c we can track contrast—it changes CT density or MR signal so we can see where it goes.
@TheAJNR 3/So if we can track how contrast gets to the tissue (by changes in CT density or MR signal), then we can approximate how BLOOD is getting to the tissue.
And how much blood is getting to the tissue is what perfusion imaging is all about.
1/Do you get a Broca’s aphasia trying remember the location of Broca's area?
Does trying to remember inferior frontal gyrus anatomy leave you speechless?
Don't be at a loss for words when it comes to Broca's area
Here’s a 🧵to help you remember the anatomy of this key region!
2/Anatomy of the inferior frontal gyrus (IFG) is best seen on the sagittal images, where it looks like the McDonald’s arches.
So, to find this area on MR, I open the sagittal images & scroll until I see the arches. When it comes to this method of finding the IFG, i’m lovin it.
3/Inferior frontal gyrus also looks like a sideways 3, if you prefer. This 3 is helpful bc the inferior frontal gyrus has 3 parts—called pars
Brain MRI anatomy is best understood in terms of both form & function.
Here’s a short thread to help you to remember important functional brain anatomy--so you truly can clinically correlate!
2/Let’s start at the top. At the vertex is the superior frontal gyrus. This is easy to remember, bc it’s at the top—and being at the top is superior. It’s like the superior king at the top of the vertex.
3/It is also easy to recognize on imaging. It looks like a big thumb pointing straight up out of the brain. I always look for that thumbs up when I am looking for the superior frontal gyrus (SFG)
If the patient is symptomatic & the greatest stenosis from the plaque is >70% of the diameter of normal distal lumen, patient will likely benefit from carotid endarterectomy
But that doesn’t mean the remaining patients are just fine!
3/Yes, carotid plaques resulting in high-grade stenosis are high risk
But assuming that stenosis is the only mechanism by which a carotid plaque is high risk is like assuming that the only way to kill someone is by strangulation.