Juan Pablo Cruz

Neurorradiologo. Terapia Endovascular. Hospital UC. INCA

[AJNR @TheAJNR]

"Endovascular Venous Sinus Stenting versus CSF Shunting for Idiopathic Intracranial Hypertension: Nationwide Real-World Outcomes"

[Neurology Journal @GreenJournal]

Clinical Reasoning: A 28-Year-Old Man With Seizures and Thalamic Lesions https://t.co/y0qsAxe2cA

#NeurologyRF

[SPIN | Society of Pediatric Neuroimaging @spinacademics]

Spin Tweetorial Wednesday 🧵
Infection-Triggered Encephalopathy Syndromes (ITES) in Children

A pattern-based overview for radiologists

[Spinal CSF Leak Foundation @spinalCSFleak]

“This report describes the CT fluoroscopy–guided circumferential EBP, a technique that achieves 360° coverage of patching material around the thecal sac using combined ventral transforaminal and dorsal interlaminar injections” https://t.co/ghY5JsWKJc From the @DukeRadiology team:

[Neurology Journal @GreenJournal]

MTORopathy With Striking Progression on Imaging in Adulthood: https://t.co/XCYutP7s1R

[Andrew L Callen MD @AndrewCallenMD]

Most patients with CSF pressure disorders don’t read the textbook.

This review is about what to do when the imaging, symptoms, and physiology don’t line up, and why “high” vs “low” pressure is often the wrong framework.

🔓Open access:

https://t.co/YnLJG2asav

[Selima Siala @selima_siala]

Excited to share our new paper just published, check it out!
https://t.co/DXFRqgIWuu
@cguimaraesMD @cesaralvesneuro
#PediNeuroRad

[American Society of Pediatric Neuroradiology @The_ASPNR]

Case of the week: A 17-year-old female patient with a 3-year history of vomiting and hiccups https://t.co/zsTnnCVo5Z Diego Cardoso Fragoso, MD; Cesar Alves, MD, PhD, Boston Children’s Hospital - Neuroradiology Division – Radiology Department #PediNeuroRad #MedEd #FOAMrad #PedsRad

[SPIN | Society of Pediatric Neuroimaging @spinacademics]

🧵 Spin Tweetorial Wednesday

When meningitis doesn’t behave… think IMMUNITY 🧠⚡

[JAMA Neurology @JAMANeuro]

This case report describes a patient who presented with a 2-day history of dizziness, unsteady gait, and confusion. In the past month, he had experienced 2 cerebral infarctions and fungal infection in his left armpit. https://t.co/NgPCI09ZkC

[Andrew L Callen MD @AndrewCallenMD]

Sacral dural tears in #SIH are probably under-recognized.

Why?
Because the sacrum often isn’t scrutinized, or sometimes even included in the field of view on routine spine imaging.

In a new multicenter @AJNR study we found:

• Sacral leaks often produce isolated sacral CSF collections
• Image-guided patching can lead to meaningful clinical & imaging improvement
• Longitudinal imaging suggests some lesions mimicking “Tarlov cysts” may actually represent chronic or partially healed leaks

Encouraging to see multicenter collaboration continue to emerge in SIH imaging/treatment research.
https://t.co/jDd8Mv0QTW

[SVIN @svinsociety]

A clearer understanding of symptomatic intracranial hypotension (SIH) starts here.

Beginning January 28, join us for a new monthly learning series covering SIH and its connection to CSF–venous disorders—featuring expert insights and a live Q&A every month.

Save your spot for the first session with Course Director Dr. Waleed Brinjikji: https://t.co/NNal062zSx

#SVIN #InterventionalNeurology #Hypotension #SIH #CSF

[AJNR @TheAJNR]

"The Role of MRA as a Preliminary Diagnostic Tool in Diagnosing and Localizing Spinal Dural Arteriovenous Fistula"

https://t.co/N7w2DK3Ugc

@The_ASSR

[Eric Topol @EricTopol]

From a new @TheLancet article today entitled "Health care in the USA: money has become the mission" https://t.co/jAjrsgJ5Zn

[Alessandro Crimi 🧠🧬🔬🩺( @alecrimi.bsky.social ) @Dr_Alex_Crimi]

Review paper arguing that the #brain has a built-in mental brake that stops unwanted thoughts. Via a fronto-temporal pathway, it relies on GABA to calm mental loops. Weak brakes may underlie #PTSD, #OCD, anxiety, and #depression https://t.co/PeisnNINEo

[JAMA Neurology @JAMANeuro]

The annual rate of first intracranial hemorrhage from unruptured brain AVMs was 1.4% in a multinational cohort, lower than commonly cited estimates.

https://t.co/tV8fDzErfe

[AJNR @TheAJNR]

"Long-Term (12 Months) Outcomes of Endovascular Thrombectomy for Large Core Stroke: A Meta‐Analysis of SELECT2, TESLA, TENSION, and LASTE Trials"

https://t.co/rxqvcpsTCI

@AliMortezaei97; @Starkeneurosurg; @DavidAltschulMD; @RahmaniRedi; @MAEssibayi; @AbdelsalamMd; @SNISinfo

[Keren Leah @KerenLeah]

🆕️ The Diagnostic Burden of Spontaneous Intracranial Hypotension: Imaging Volume and Specialists Involvement Prior to Diagnosis

✒️ @parnian_habibi et al. via @TheAJNR

🧠💧 #spinalCSFleak #CSFleak #SIH #CSFVF #NeuroRad #NeuroX https://t.co/UxdTXD7qjM

[JNIS @JNIS_BMJ]

🧠 More literature demonstrating the value of single-phase CTA in the prognostication of large vessel occlusion patients. Combining the Tan (arterial) and COVES (venous), the CTA Collateral Impairment Score predicts 90-day functional outcome. Great, especially in settings without access to CTP! https://t.co/4OKYBiiJyE

[Michael Okun @MichaelOkun]

To shunt or not to shunt, that is the (NPH) question? The first large randomized trial of shunting for normal pressure hydrocephalus (NPH) just dropped in NEJM, and there was clear benefit for walking, and it favored the group receiving shunts. Spoiler alert: Walking improved, however thinking (cognition) and bladder function did not.
Key Points:
- NPH is a condition usually presenting in older adults where fluid builds up in the brain and it associated w/ trouble walking, memory and thinking challenges as well as bladder incontinence.
- Shunting significantly improved walking speed and balance compared w/ placebo.
- No meaningful change in cognition or bladder control observed at 3 months.
- Risks included subdural bleeding and headaches, underscoring the need for careful follow up.
My take: NPH has always been a tricky area for clinicians when trying to decidr 'to shunt or not to shunt.' Here are 5 points that resonated w/ me: 1- Shunting in well selected persons can restore some walking ability in NPH. 2- Thinking did not improve at 3 months. 3- Incontinence showed no clear benefit. 4- Risks to always discuss w/ people considering shunts should include bleeding and headaches (as not uncommon). 5- Walking gains may possibly reduce falls and boost independence, however we must be careful as sometimes improved walking w/o improved balance, can actually trigger falls.
https://t.co/yCnSCpclPL @FixelInstitute @ParkinsonDotOrg @alzassociation @SfNtweets @SfNtweets @NEJM