Magdi Mahsoub

(حسبنا الله سيؤتينا الله من فضله إنا إلى الله راغبون)

[Dr sthanu subramanian @drsthanus]

This teenaged boy of nonconsanguineous parents presented with abnormal body movements, gait difficulty, and slurring of speech for 2 years.

Findings?

Diagnosis?

[Magdi Mahsoub @magdimahsoub]

@YSgZOmgLBLJHDsj 👍

[RADIOLOGISTS @DrAyubaD]

Middle-aged patient found unconscious in a closed room with a faulty heater. Now with headache, confusion and cherry-red skin.

What is the diagnosis ?

[Annals of Indian Academy of Neurology @AnnIndAcadNeur]

CTX should be suspected in any patient
with childhood cataracts, tendon xanthomas & neurological findings of ataxia, spasticity, extrapyramidal features & dementia. MRI reveals B/L cerebellar atrophy and dentate hyperintensitites. CTX -> treatable
Link: 10.4103/aian.AIAN_126_18

[Lea Alhilali, MD @teachplaygrub]

Feel like waving the white flag over white matter disease?

Do you grade the degree of small vessel disease, or just mention & hope no one asks for more?

Degree of small vessel disease is important & the Fazekas scale is an easy way to semi-quantitate disease burden

Here’s how to remember it:

Think about how the number looks or feels — it grows in intensity!

Deep White Matter Fazekas:
1 → “1-hit wonder”
   Punctate foci — just tiny spots, like little dots.
2 → “2 = two-gether”
Beginning confluence of foci — two dots coming together, mild merging.
3 → “3 is a crowd”
Large, confluent areas — everything blending into a mess, too much white.

Periventricular Fazekas:
1 → “1 is a pencil”
✏️ Pencil looks a number 1 (pencil-thin “cap” or rim along ventricle).
2 → “2 curves into a halo”
⭕ Smooth halo of hyperintensity — picture the roundness of 2 encircling the ventricle.
3 → “3 branches out”
🌿 Irregular fingers of white matter reaching into the deep — the edge of the number 3 look like irregular finger

Now you know the Fazekas score for small vessel disease!

Now your knowledge of small vessel disease will be anything but small!

[Arthroscopy Journal @ArthroscopyJ]

Reverse Ramp Lesion Repair in Patients With Meniscotibial Ligament Avulsion Injury: The Hidden AMRI https://t.co/8GEgA6zLSZ #knee #arthroscopy

[SPIN | Society of Pediatric Neuroimaging @spinacademics]

🧠 #SPINTweetorialWednesday

🧩 Case Challenge

A 2½-year-old child develops rapid neurological deterioration after a viral respiratory illness.

What's your diagnosis?

[Dr. OMID BANDARCHI @OBandarchi]

🛑MCL bursa located along the middle 1/3 of the medial aspect of knee between superficial & deep portions of MCL.
🛑MCL bursitis is rare. Calcification of MCL is also rare but found either inside the bursa (calcific bursitis) or outside of it confused with meniscal tears,gout,..

[Dr sthanu subramanian @drsthanus]

A previously healthy man in his 50s presented with progressively worsening headaches and bluish nodular skin lesions.

Fast-field echo MRI image of the brain 👇

Likely diagnosis?

[Dr.Haitham Hamoud | د.هيثم @hemo_shk]

What is the finding and diagnosis?

[RADIOLOGISTS @DrAyubaD]

SHRIMP SIGN is seen in which condition?

#MedX #FOAMrad #Radiology

[RADIOLOGISTS @DrAyubaD]

EASY ONE 🔥🔥

Young adult with headache, ataxia and signs of raised ICP.

Spot the abnormality? 👇

#MedX #Radiology #FOAMrad #NeuroRad

[Dr.Haitham Hamoud | د.هيثم @hemo_shk]

A patient presents with headaches, hearing loss, and says their hat no longer fits.

❓ What is the most likely diagnosis?

[Annals of Indian Academy of Neurology @AnnIndAcadNeur]

Shrimp sign has an 85% sensitivity, 100% specificity and 100% PPV for diagnosing PML. Asymmetry of the MCP lesions is paramount! Ajay Garg et al published one such case highlighting the "Shrimp sign" 🍤 in PML. @neuro_ian #PML Link: 10.4103/aian.aian_932_23

[The Cortex Club @thecortexclub]

Polypoid lesions in the sinonasal region are mostly mucosal polyps but if you see a 'cerebriform' appearance (aqua arrows), especially one associated with a bony spur (chartreuse arrows), think Inverted papilloma! The bone spur must come out, to avoid recurrence.

[Annals of Indian Academy of Neurology @AnnIndAcadNeur]

Olivary hypertrophy is an exceptional consequence of brainstem insults. Usually occurs after a latency period of few months. @atabisneuro et al reported a case of bilateral olivary degeneration following Scrub typhus rhombencephalitis @neuro_ian Link: 10.4103/aian.aian_931_23

[Whitfield Lewis, MD 🇦🇬🇺🇸 @whitfieldlewis6]

Top 3 most common causes of hemorrhagic metastatic lesions to the brain include?

How would you treat the edema caused by the tumor?

Drop your thought below
👇👇

[Daniel Gewolb, MD @daniel_gewolb]

⭐️ ~17% of patients with classic trigeminal neuralgia have aberrant nerve anatomy which may cause or contribute to their symptoms and is associated with worse surgical outcomes! ⚡️

⭐️ In patients with classic trigeminal neuralgia: Check the angle of the trigeminal nerve as it crosses through the porus trigeminus into Meckel's cave!

🔷Case example in 🧵

#Neurology #Neurosurgery #radres #futureradres #Medicine #MRI #FOAMed @ASNRographics @TheAJNR @Radiopaedia

[Daniel Gewolb, MD @daniel_gewolb]

⭐️ Classic: What is the most likely diagnosis in this 30 y/o M presenting w/ acute dysarthria/dystaxia?

Additional image in 🧵

#Medicine #Neurology #radres #futureradres #Neurosurgery #MRI #FOAMed @Radiopaedia

[SPIN | Society of Pediatric Neuroimaging @spinacademics]

#SPINTweetorialWednesday 🧵
Hypothalamic Hamartoma: The Little Lesion That Laughs ⚡🧠

A benign developmental malformation with a striking clinical signature:

😂 Gelastic seizures
⏩ Precocious puberty
🧠 Cognitive and behavioral disturbances

Let's dive in. 👇