▶️Headache that is worst when upright and improves with lying flat as it gets the sagging brain off the jagged skull base (at least that’s how I remember it)
💡May also present with chronic headaches or without headaches
Aug 28 • 8 tweets • 3 min read
What is the most likely diagnosis in this patient with sensorineural hearing loss and fullness of the neck? 🧠
Imaging:
▶️ROUNDED morphology with more vertical and medial orientation (yellow arrow)
▶️DEEP more VERTICALLY oriented COLLATERAL SULCUS (blue arrow)
▶️Blurred hippocampal structure
▶️NORMAL SIZE AND SIGNAL (different from MTS)
▶️Enlarged-appearing temporal horn 🧠
Jul 1 • 5 tweets • 2 min read
Hypertensive and cerebral amyloid angiopathy are 2 of the most common causes of intracranial micro-hemorrhage 🧠
💡Recognizing the pattern of micro bleeds can help determine etiology
#NeuroTwitter #radres #Neurology #Neurosurgery #MedEd #MedTwitter
💡 Typical hypertensive micro bleed pattern (best seen on SWI/T2*):
▶️Deep gray matter
▶️Brainstem
▶️Less commonly, peripheral
💡 Hypertensive angiopathy can result in both hemorrhage or ischemia
Jun 10 • 14 tweets • 10 min read
Differential Diagnosis for cortically based masses
▶️Susac syndrome is a microangiopathy (likely autoimmune affecting the precapillary arterioles) with a strong female predilection, typically occurring in women age 20-40
May 27 • 14 tweets • 7 min read
Tips & tricks of DWI to help narrow the differential
Ddx:
Stroke
Abscess
Hypercellular tumor
Hematoma
Epidermoid cyst
Encephalitis
Seizure
Demyelination
Toxic/metabolic disorders
CJD
Other stuff I’m forgetting #Neurology#neurosurgery#radres#MedTwitter#MedEd@TheASNR
Anything that traps fluid can restrict diffusion! Here are some tricks I use to narrow the ddx
1️⃣STROKE
Cytotoxic edema due to trapped intracellular fluid leads to restriction
Look for wedge shaped restriction in a vascular territory
May 25 • 7 tweets • 4 min read
Child with a history of dental caries presents with a firm mass at the angle of the mandible. What is the most likely diagnosis? 🤔 🧠
Epiglottitis is an emergency as it can potentially cause airway compromise especially in children who have smaller airways #neurotwitter#ent#peds#Neurosurgery#MedTwitter#MedEd@ASHNRSociety
▶️In children the diagnosis can be confirmed with upright plain film. CT requires placing the patient supine which may exacerbate inspiratory strider
▶️In adults, the diagnosis may not be suspected clinically so patients may end up with a CT scan as in this case
May 21 • 6 tweets • 5 min read
Case of diffuse CSF seeding of tumor in this patient w/ WHO grade 4 diffuse hemispheric glioma
Learning case in this 40 y/o F with history of whole brain radiation as a child for brain tumor treatment #NeuroRad#neurosurgery#Neurology@TheASNR#NeuroTwitter#meded#radres
Brain radiation is a risk factor for the development of meningiomas …this patient subsequently developed multiple meningiomas including this large frontal meningioma
May 19 • 9 tweets • 5 min read
Interesting case of complicated acute bacterial rhinosinusitis in this child with no PMH presenting w/ HA, fever & L sided weakness