Richard Hammerdongle MD

Neuroradiologist and Neuroimaging Enthusiast

[Richard Hammerdongle MD @Hammerdongle]

For those interested in hippocampal anatomy.

https://t.co/xiPcOfhfup

#FOAMed #FOAMrad #radres #NeuroRad #radiology #Neurology

[Richard Hammerdongle MD @Hammerdongle]

Dick's Pick of the Week: Osmotic Demyelination Syndrome: both pontine and extra pontine.

Pontine and capsular involvement and globus sparing helps differentiate from anoxic injury.

#FOAMed #FOAMrad #radres #NeuroRad #radiology #Neurology

[Richard Hammerdongle MD @Hammerdongle]

Dick's Pick of the Week: Hemodialysis Spondyloarthropathy

Findings: Vertebral endplate destruction and collapse at C7-T1 with well defined "punched out" erosions. Marrow signal more T2 hypointense than expected for discitis.

#FOAMed #FOAMrad #radres #NeuroRad #radiology

[Richard Hammerdongle MD @Hammerdongle]

Dick's Pick of the Week: Cortical-Gyral Anomalies

Pachygyria, polymicrogyria, and stenogyria

#FOAMed #FOAMrad #radres #NeuroRad #radiology #Neurology

[Richard Hammerdongle MD @Hammerdongle]

Dural Arteriovenous Fistula

Findings: Serpiginous irregular hypertrophied occipital-dural feeding arteries with early filling of the sigmoid sinus and IJV.

#FOAMed #FOAMrad #radres #NeuroRad #radiology #Neurology

[Richard Hammerdongle MD @Hammerdongle]

DWI/SWI blood physics

T2 bright blood stages will be DWI/SWI bright and diffusion restrict.
T2 dark blood stages will maintain DWI/SWI hypointensity and may obscure areas of ischemic infarct due to hemorrhagic conversion.

#FOAMed #FOAMrad #radres #NeuroRad #radiology #Neurology

[Richard Hammerdongle MD @Hammerdongle]

DWI stroke physics

Proton diffusion correlates with T2 signal loss on b1000. ADC signal intensity correlates with the degree of proton diffusion and T2 signal loss.

Proton diffusion: CSF > brain > cytotoxic edema

#FOAMed #FOAMrad #radres #NeuroRad #radiology #Neurology

[Richard Hammerdongle MD @Hammerdongle]

Dick's Pick of the Week: Carotid Intraluminal Thrombus

Imaging findings: Intraluminal filling defect completely surrounded by contrast on two contiguous axial source images "donut sign".

#FOAMed #FOAMrad #radres #NeuroRad #radiology #Neurology

[Richard Hammerdongle MD @Hammerdongle]

@DrAsadMunir A tear in the arachnoid meningeal layer which would allow CSF from the subarachnoid space to enter the subdural space.

[Richard Hammerdongle MD @Hammerdongle]

Dick's Pick of the Week: Acute traumatic arachnoid tear and SDH.

Mixed density SDH could be due to varying ages of hemorrhage, active bleeding, or *combined acute arachnoid tear and SDH with intermixed CSF and hyperdense blood*.

#FOAMed #FOAMrad #radres #NeuroRad #radiology

[Richard Hammerdongle MD @Hammerdongle]

@neurotriv @EricLawson90 @JAMANeuro @DiogoHaussen @EmoryNeurology Doesn't seem to be a clear consensus on medical therapy vs stenting or surgery. Nevertheless, it should be addressed.

[Richard Hammerdongle MD @Hammerdongle]

Dick's Pick of the Week: Carotid Web

Subtype of fibromuscular dysplasia and thromboembolic nidus.

“Shelf-like” intraluminal filling defect arising from the posterior margin of the ICA origin and projecting cephalad.

#FOAMed #FOAMrad #radres #NeuroRad #radiology #Neurology

[Richard Hammerdongle MD @Hammerdongle]

@RyanBPetersonMD @Nkpiano @JudyGadde @nakoontz @EmoryRadiology @JeffersonRads @TheASNR @ASER_ERad @gennadanna @CincyPedsNeuro @EmoryNeurology @ClarkDRogers Guilty

[Richard Hammerdongle MD @Hammerdongle]

Dick's Pick of the Week: Neurogenic Arthropathy

Extensive hypertrophic vertebral endplate and facet destruction, preserved bone density, widened joint space, surrounding bony debris and associated pseudoarthrosis.

#FOAMed #FOAMrad #radres #NeuroRad #radiology #Neurology

[Richard Hammerdongle MD @Hammerdongle]

@stickymiser @nuromri Yep

[Richard Hammerdongle MD @Hammerdongle]

Dick's Pick of the Week: Inflammatory-Cerebral Amyloid Angiopathy

Findings: Multifocal leptomeningeal enhancement, lobar vasogenic edema, and peripheral cerebral microbleeds and superficial siderosis.

#FOAMed #FOAMrad #radres #NeuroRad #radiology #Neurology

[Richard Hammerdongle MD @Hammerdongle]

@RyanBPetersonMD @JudyGadde @nakoontz @EmoryRadiology @IURadiology @JeffersonRads @ASER_ERad @CincyPedsNeuro @gennadanna @TheASNR @RyanChristieMD

[Richard Hammerdongle MD @Hammerdongle]

@DrNeuro123 Typical: juxtacortical vasogenic edema within the posterior circulation (posterior cerebral and cerebellar hemispheres).

Pontine predominant PRES is relatively rare.

[Richard Hammerdongle MD @Hammerdongle]

Dick's Pick of the Week: Pontine PRES (posterior reversible encephalopathy syndrome)

Findings: Reversible vasogenic edema within the pons, infratentorial white matter, and internal capsules consistent with pontine predominant PRES.

#FOAMed #FOAMrad #radres #NeuroRad #radiology

[Richard Hammerdongle MD @Hammerdongle]

Dick's Pick of the Week: Intravascular Lymphoma: presenting as internal border zone infarcts

Findings: IBZ infarcts of varying ages and faint basal ganglia enhancement, likely due to IVL predilection for deep penetrating arteries.

#FOAMed #FOAMrad #radres #NeuroRad #radiology