Retina Afreen

I Say The Truth.

[Lea Alhilali, MD @teachplaygrub]

Is trying to remember toxic encephalopathy patterns making you toxic?

Does memorizing metabolic encephalopathy patterns put you into a metabolic coma?

Don't become encephalopathic!

Here is the cheat sheet of the encephalopathy patterns you NEED to know & how to remember them!

➡️Corpus Callosum:
🔸Lesions here are called cytotoxic lesions of the corpus callosum or CLOCC.
🔸Usually transient from cytotoxicity, especially viral infections.
🔸Remember they are commonly viral & transient bc CLOCC lesions are on the CLOCK

➡️Central Pons:
🔸Usually osmotic demyelination
🔸Remember this bc the T2 hyperintensity is in the shape of O for Osmotic

➡️Dentate:
🔸Usually flagyl toxicity
🔸Remember this bc the wavy appearance of the dentate looks like a FLAG for FLAGyl

➡️Corticospinal tract:
🔸Usually from cobalamin deficienty
🔸Remember cortiCOspinal for CObalamin

➡️Symmetric Gray Matter:
🔸Differential is EXTENSIVE
🔸Remember the differential list for deep gray is deep!

➡️Cortical Gray Matter:
🔸Typically hypoglycemia & hyperammonemia
🔸Remember it looks like the brain has been coated in shimmering sugar = related to glucose
🔸Hyperammonemia has about 1000 Ms in it & the undulated cortex looks like an M

➡️Symmetric White Matter:
🔸Commonly from chasing the dragon (heroin) & methotrexate
🔸Remember that the puffy white matter signal looks like the smoke from a dragon
🔸Remember methotrexate as methoTRACTSate = affects many white matter TRACTS

➡️Posterior subcortical edema:
🔸This is PRES or posterior reversible encephalopathy
🔸So if it’s all POSTERIOR, think POSTERIOR reversible encephalopathy

➡️Asymmetric White Matter:
🔸This is usually demyelinating from chemotherapy
🔸Demyelinating lesions have a C shaped pattern of enhancement
🔸So if you see a C enhancing think of C-hemotherapy

Now you know all the toxic/metabolic encephalopathy patterns.

So hopefully now remembering the patterns of toxic/metabolic won’t seem so diabolic!

[Nat Rev Neurology @NatRevNeurol]

New online! Urogenital dysfunction in neurological diseases https://t.co/TMvh3ghod0

[Curious Minds @CuriousMindsHub]

Brain regions associated handwriting vs. typewriting

[WalidoNeuroPedia @NeuroWalid]

#bookmark:
Clinical and radiologic findings of higher cortical visual disorders.
#neurotip #neuroanatomy
Made by @neurowalid

[WalidoNeuroPedia @NeuroWalid]

Stroke Size classification as per ELAN trial:

[WalidoNeuroPedia @NeuroWalid]

An easy way to differentiate these midbrain syndromes is to remember that, moving from anterior to posterior, all three involve oculomotor nerve damage, with additional distinct features:

Weber’s syndrome – affects the anterior midbrain, involving the corticospinal tracts, leading to contralateral weakness.

Benedikt’s syndrome – involves the mid-midbrain, including the red nucleus, causing abnormal involuntary movements such as tremor and chorea.

Claude’s syndrome – localized to the posterior midbrain, where superior cerebellar peduncle fibers (after decussation) are affected, resulting in cerebellar signs (think Claude = Cerebellar).

#Neurotip

[Oren Gottfried, MD @OGdukeneurosurg]

Tract of the spine by @medics_AbuSaif

[Oren Gottfried, MD @OGdukeneurosurg]

Awesome brain anatomy information from @medics_AbuSaif

[Dr. Mustafa K. Baskaya, MD @DrBaskaya]

🎥 New Neurosurg Focus Video (Jan 2026)
Microsurgical resection of anterior clinoidal meningiomas with arterial engulfment.
🧠 ICA/AChA encasement • ICG + neuromonitoring • Neurovascular preservation
🔗 https://t.co/RUl24WhpiJ
#Neurosurgery #SkullBase #Neurovascular

[theRadiologist @radiologistpage]

Lumbar spine MRI anatomy and nomenclature

[Seraj Ajaj @seraj25]

Chater's point
6cm above the EAM on a line
perpendicular to the orbitomeatal line;= 1.5cm above the squamosal suture along the same perpendicular line.
A 4cm craniotomy centered at Chater's point provides access to recipient vessels in the angular gyrus for EC/IC bypass surgery

[Oren Gottfried, MD @OGdukeneurosurg]

Pituitary

[Dr. Mustafa K. Baskaya, MD @DrBaskaya]

🧠 AComA aneurysms: microsurgical clipping still offers superior long-term durability.
🔗 https://t.co/zeMMLaQvEY
#Neurosurgery #Cerebrovascular #Microsurgery #Neurovascular #Aneurysm

[UofL Neurosurgery @UofLNeurosurg]

The snow isn't stopping our residents!

Dr. Ziqi Wang, PGY-1, and Dr. Elizabeth Bridwell, PGY-2, performed bilateral burr holes for a chronic subdural hematoma during the snowstorm.

#Neurosurgery #UofLNeurosurgery @uofl @uoflmedschool @UofLHealth

[Journal of Neurosurgery @TheJNS]

#OnlineFirst: Morphological characteristics of healthy and aneurysmal internal carotid artery bifurcations.

https://t.co/92hgWzmps5

[Oren Gottfried, MD @OGdukeneurosurg]

What is it !

[Oren Gottfried, MD @OGdukeneurosurg]

Aneurysm types from Othman

[Dr. Mustafa K. Baskaya, MD @DrBaskaya]

🧠🎥 New operative video in JNS Reports Microsurgical resection of diaphragma sellae meningioma with extradural clinoidectomy and preservation of superior hypophyseal arteries.
📄 DOI: 10.1055/a-2765-5582 🔗 https://t.co/jf00RfK4gK
#Neurosurgery #SkullBase #UWHealth #UWMadison

[Neuroanatomy Research group @NeuroanatomyRG]

Precision matters.... ➪🧠
External Ventricular Drain (𝗘𝗩𝗗) insertion is all about surface landmarks:
- 𝗘ntery point.
- 𝗧rajectory.
- 𝗩𝗲𝗻𝘁𝗿𝗶𝗰𝘂𝗹𝗮𝗿 - Target.

𝗥especting ventricular anatomy—small angles, big consequences.

[Dr. Zhong @pzhong2016]

Cardiac conduction axis: Anatomic location