Post

How to get URL link on X (Twitter) App

On the Twitter thread, click on or icon on the bottom
Click again on or Share Via icon
Click on Copy Link to Tweet
Paste it above and click "Unroll Thread"!
More info at Twitter Help

Lea Alhilali, MD

@teachplaygrub

Jan 14, 2023 • 12 tweets • 7 min read • Read on X

Scrolly

1/Is your ability to remember temporal lobe anatomy seem, well, temporary?

Here’s a #tweetorial to help you remember the structures of the temporal lobe!

#medtwitter #meded #neurotwitter #radtwitter #radres #neurorad #FOAMed #neurosurgery #medstudenttwitter #neurology

2/Temporal lobe can be divided centrally & peripherally. Centrally is the hippocampus. It’s a very old part of the brain & is relatively well preserved going all the way back to rats. Its main function is memory—getting both rats & us through mazes—including the maze of life

3/Peripherally is the neocortex. Although rats also have neocortex, theirs is much different structurally than humans.

So I like to think of neocortex as providing the newer (neo) functions of the temporal lobes seen in humans: speech, language, visual processing/social cues

4/So let’s start w/the oldest part of the temporal lobe, the hippocampus, and we will move clockwise from there.

5/Next to the hippocampus is the parahippocampal gyrus. I remember this b/c the hippocampus is the oldest part of the temporal lobe & older folks love to go in pairs. So this is the PAIR-ahippocampal gyrus—it pairs w/the old hippocampus

6/Next to the parahippocampal gyrus is the fusiform gyrus. I remember this b/c this gyrus bridges (some might say FUSES) the older, allocortex part of the temporal lobe (hippocampus/parahippocampal) w/the newer, neocortical structures. Fusiform gyrus is the neocortical bridge

7/Fusiform gyrus bridges the older temporal lobe w/the new lateral temporal neocortex.

I think the lateral neocortex looks like a parfait—w/the superior, middle, & inferior temporal gyri layered on top of the fusiform gyrus. Heschl’s transverse gyrus forms the strawberry on top

8/You can remember that the fusiform gyrus is at the bottom of this parfait b/c fusiform means elongated—and the stem of a parfait glass is elongated—almost fusiform!

9/You can remember that Heschl’s gyrus is the fruit on top b/c Heschl sounds like Bushel, and fruit to put on top comes in Bushels!

10/You can also see this parfait in the coronal plane, although it is a little tilted!

11/Last temporal lobe structure is the temporal stem. It is the white matter connecting the gyri of the temporal lobe to the rest of the brain. I remember this b/c I think the temporal lobe looks like an upside-down cauliflower—& the STEM of that cauliflower is the temporal STEM

12/So now you can remember the anatomy of the temporal lobe:

An old couple

A bridge fusing them to the next generation

A delicious parfait

All connected by a cauliflower stem.

I hope this new anatomy knowledge will be anything but temporary!

• • •

Missing some Tweet in this thread? You can try to force a refresh

This Thread may be Removed Anytime!

Twitter may remove this content at anytime! Save it as PDF for later use!

More from @teachplaygrub

Lea Alhilali, MD

@teachplaygrub

Dec 19

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

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

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

Lea Alhilali, MD

@teachplaygrub

Nov 27

1/Controversy in radiology can get tense!

The Mt Fuji sign for tension pnemocephalus is under scrutiny. When should you call it?

A thread about imaging this important neurosurgery complication

2/First, let’s clarify about what the Mt Fuji sign actually is

Most are familiar with the fact that large collections of pneumocephalus can compress the frontal lobes—making them look like the slopes of a mountain

But this isn’t actually enough to call Mt Fuji.

3/You also need to see frontal lobe separation

This means subdural air tension > the CSF surface tension between the frontal lobes

Water has one of the highest liquid surface tensions—so means pressure is high

This little V is why it looks like Mt Fuji, not any mountain

Read 9 tweets

Lea Alhilali, MD

@teachplaygrub

Nov 25

1/The medulla is anything but DULL!

Does seeing an infarct in the medulla cause your heart to skip a beat?

Does medullary anatomy send you into respiratory arrest?

Never fear, here is a thread on the major medullary syndromes!

2/The medulla is like a toll road.

Everything going down into the cord must pass through the medulla & everything from the cord going back up to the brain must too.

That’s a lot of tracts for a very small territory. Luckily you don’t need to know every tract

3/Medulla has 4 main vascular territories, spread out like a fan: anteromedial, anterolateral, lateral, and posterior.

You don’t need to remember their names, just the territory they cover—and I’ll show you how

Read 18 tweets

Lea Alhilali, MD

@teachplaygrub

Nov 20

1/Time to rupture all your misconceptions about aneurysms!

When you see an aneurysm on imaging, do you know if it’s at high risk of rupture?

This month’s @theAJNR SCANtastic shows you which aneurysms are bursting w/risk!

ajnr.org/content/45/11/…

2/Aneurysm rupture is a devastating even, as it results in subarachnoid hemorrhage & complications such as hydrocephalus, vasospasm, infarcts, & death.

Preventing it by treating aneurysms before they rupture is key. But you also don’t want to overtreat.

3/To remember what features make an aneurysm more likely to rupture, think what makes that guy at the bar that you angered more likely to rupture & start a fight.

What makes him more likely to rupture are the same things that make aneurysms more likely to rupture

Read 19 tweets

Support us! We are indie developers!

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

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Don't want to be a Premium member but still want to support us?

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

Donate via Paypal

Or Donate anonymously using crypto!

Ethereum

0xfe58350B80634f60Fa6Dc149a72b4DFbc17D341E copy

Bitcoin

3ATGMxNzCUFzxpMCHL5sWSt4DVtS8UqXpi copy

Thank you for your support!

Share this page!

Enter URL or ID to Unroll

Lea Alhilali, MD

Try unrolling a thread yourself!

More from @teachplaygrub

Lea Alhilali, MD

Lea Alhilali, MD

Lea Alhilali, MD

Lea Alhilali, MD

Lea Alhilali, MD

Lea Alhilali, MD

Did Thread Reader help you today?

Don't want to be a Premium member but still want to support us?

Send Email!