Dr. Carlos Argel

[Dr. Carlos Argel @CarlitoxAriel]

@Dua_aborigen @ingdroop

[Dr. Carlos Argel @CarlitoxAriel]

@MONAQUILOMBERA Cementerio de canelones

[Dr. Carlos Argel @CarlitoxAriel]

@DocNavarrow Tbc

[Doc Navarrow @DocNavarrow]

🧠💡 Enhancing tumor… pilocytic astrocytoma or high-grade astrocytoma?

Advanced MRI clues:

• ↓ rCBV + ↑ ADC → favors PA
• ↑ rCBV + ↓ ADC → favors high-grade

Perfusion outperforms diffusion.

But beware… overlap exists. Imaging ≠ histology.

https://t.co/YHzBZQVwRK

[Pablo C @PabloCastroDice]

Después de más de 7 años ejerciendo como psicólogo, veo que muchas parejas se enfrían en menos de 2 años.

No es el estrés, ni los niños, ni la edad.

Son estos 5 conceptos…

[Ladytron Fan Account @Lady_FanAccount]

Kings Of Leon - Use Somebody

https://t.co/pjbSa4JafU

[Oasis Archives🍋 @OasisArchives]

The Verve - Lucky Man (1997)

[Cyber Punk @11cyberpunk]

Arctic Monkeys - Do I Wanna Know?

[songs that changed history @iconiksongs]

25 years ago, coldplay released ‘yellow’

[songs that changed history @iconiksongs]

30 years ago, alanis morissette released “ironic” https://t.co/LdE4d9ulHd

[Dr.Marlon Villanueva™ 🩺 𝕏 @MarlonVFZR]

🧠𝗔𝗦𝗣𝗘𝗖𝗧𝗦🔥
⬇️⬇️⬇️⬇️

📊 ¿𝙌𝙪𝙚́ 𝙚𝙨 𝘼𝙎𝙋𝙀𝘾𝙏𝙎?

🧠 TAC simple
🎯 Territorio 𝘼𝘾𝙈
🔢 Puntaje 𝟭𝟬 → 𝟬
➖ 1 punto por 𝙨𝙞𝙜𝙣𝙤 𝙞𝙨𝙦𝙪𝙚́𝙢𝙞𝙘𝙤 𝙩𝙚𝙢𝙥𝙧𝙖𝙣𝙤

🗺️ 𝙕𝙤𝙣𝙖𝙨 (𝟭𝟬 𝙥𝙪𝙣𝙩𝙤𝙨)

🧩 Ganglios basales (4)
•Caudado
•Putamen
•Cápsula interna
•Ínsula

🧠 Corteza ACM (6)
•M1–M6 (anterior → posterior)

⏱️ ¿𝙌𝙪𝙚́ 𝙧𝙚𝙨𝙩𝙖 𝙥𝙪𝙣𝙩𝙤𝙨?

❌ Hipodensidad
❌ Pérdida diferenciación gris-blanco
❌ Borramiento surcos

🚑 𝙄𝙣𝙩𝙚𝙧𝙥𝙧𝙚𝙩𝙖𝙘𝙞𝙤́𝙣 𝙘𝙧𝙞́𝙩𝙞𝙘𝙖 𝙐𝘾𝙄

✅ 𝘼𝙎𝙋𝙀𝘾𝙏𝙎 ≥ 𝟲
→ Candidato a 𝙩𝙧𝙤𝙢𝙗𝙚𝙘𝙩𝙤𝙢𝙞́𝙖 🧲
→ Mejor pronóstico funcional

⚠️ 𝘼𝙎𝙋𝙀𝘾𝙏𝙎 < 𝟲
→ Core grande 🧠💥
→ ↑ riesgo HIC / mal pronóstico
→ Individualizar EVT

💉 𝘼𝙎𝙋𝙀𝘾𝙏𝙎 + 𝙧𝙚𝙥𝙚𝙧𝙛𝙪𝙨𝙞𝙤́𝙣

🕒 Ventana extendida + ASPECTS adecuado
➡️ 𝙀𝙑𝙏 𝙞𝙣𝙘𝙡𝙪𝙨𝙤 >𝟲 𝙝
📊 Decisión ≠ tiempo solo

🧠 Regla UCI

💎 Dato clave

👁️ TAC simple + ASPECTS
⚡ Más rápido que perfusión
🧠 Suficiente para decidir en guardia

👇🏼👇🏼👇🏼👇🏼
📚📖#ClubCrit

#NeuroX #Stroke #ASPECTS #CritCare #UCI #ICU #CriticalCare #Diagnóstico #icu #intensivecare #diagnosis #management #POCUS #MedicinaBasadaEnEvidencia #Terapia #MedEd #Medicina #FOAMed #FOAMcc #CuidadoCrítico #MedX #EducaciónMédica #MedIntensiva #MedXCommunity #MedicinaCrítica #MedED #CritCare #ICUManagement #MustRead #LecturaRecomendada

[ESNR @ESNRad]

ESNR Case of the Month: A Rare Midbrain Tumour
Presented by Dr May Ting Tan. Our first-ever Case of the Month features a 21-year-old with a tectal plate lesion. MRI clues pointed the way, but biopsy confirmed a midbrain germinoma. Stay tuned 🧠

[Dr Harun Yıldız @drharunyildiz]

Gliomatosis Cerebri
vs
Lymphomatosis Cerebri

https://t.co/qjIIqRnat3
https://t.co/pd2eksVTW0

#radiologicalillustration
pixel by pixel handmade!

[ILLIASUL IBAD @IlliasulK]

Clinical pearl:

Hypophysitis + diabetes insipidus + hypertrophic pachymeningitis is a pattern.

Once infection & malignancy are excluded, this triad should narrow your thinking to two diagnoses:(keep sarcoid and AAV in mind)

IgG4-related disease

→ Fibro-inflammatory, steroid-responsive

• Pachymeningitis + hypophysitis are classic
• DI common
• Disease of the coverings (dura, skull base, pituitary)
• Brain parenchyma usually spared

Erdheim–Chester disease (ECD)

→ Histiocytic, often steroid-refractory
• DI very common
• Pachymeninges + parenchymal CNS involvement
• Brainstem & cerebellum > hemispheres
• Cerebellar atrophy / neurodegeneration may be seen
• Multisystem involvement common

🧠 Why rheumatologists care:

👉 One responds dramatically to steroids

👉 The other needs targeted therapy (BRAF/MEK)

Rule of thumb:

Parenchymal or degenerative CNS disease tips the diagnosis toward ECD.

#Rheumatology #NeuroRheum #IgG4RD #ErdheimChester #ClinicalReasoning #MedTwitter @DrAkhilX @IhabFathiSulima @CelestinoGutirr @DurgaPrasannaM1

[Lea Alhilali, MD @teachplaygrub]

Need a DURABLE way to remember what causes DURAL enhancement?

Feeling left behind when it comes to leptomeningeal disease?

Here’s an easy way to remember the differential diagnoses for the two types of meningeal enhancement:

LEPTOMENINGEAL
Remember:
L = Leakage (subarachnoid hemorrhage)
E = Epilepsy (recent seizure)
P = Pus (infection, either bacterial, viral or granulomatous/fungal)
T = Tumor (leptomeningeal metastatic dz)
O = Operation (post operative)

PACHYMENINGEAL
Remember
P = Puncture (recent LP), Pus (subdural empyema)
A = Autoimmune (sarcoidosis, IgG4)
C = Craniotomy (post-op), Chronic subdural
H = Hypotension (intracranial hypotension)
Y = You’ve got a mass (mets, usually from direct bony extension, meningioma)

Now you’ve got a lot information PACH-ed into an easy & memorable mnemonic!

[Dr. Carlos Argel @CarlitoxAriel]

@DocNavarrow Sarcoidosis orbitaria?

[ᴀʀʏᴀ @juegoofthrones]

Septiembre con S de:

"Si sus sentimientos son los mismos que en abril, dígalo de una vez.
Mi afecto y mis deseos no han cambiado, pero una palabra suya me silenciará para siempre".

[Dr. Carlos Argel @CarlitoxAriel]

@aagripinaa Estoy esperando que pasen el link para la votación. O no era así??

[Dr. Carlos Argel @CarlitoxAriel]

@TronkOficial Se rompió la manija del horno?

[Dr. Carlos Argel @CarlitoxAriel]

@GH2022Val Por la cabeza de Eugenia “más falso este tipo”