Pedro Ponce Marrero

Neuro-Rad HUGCDN

[International Journal of Stroke @IntJStroke]

📊TENSION trial results are reproducible in routine care
🇩🇪🧠German Stroke Registry data shows similar 90‑day results to the RCT, supporting wider adoption of thrombectomy for large‑infarct stroke

https://t.co/OYqxkT0mrK @WinkelmeierMD @Fie0815 @FabianFlottmann @MDoctoronboard

[MediSueldos @medisueldos]

El truco es ocultar el tiempo. Nos exigen 2.598h/año (4 meses extra). ¿Qué pasaría si TODO el hospital trabajara nuestra jornada?

He corrido la simulación.

La brecha colapsa.

[Neurochecklists @neurochecklists]

We have just updated our MS poor prognostic factors checklist with this paper https://t.co/YrtTIIjFZA

[JNIS @JNIS_BMJ]

🔊 Sigmoid plate dehiscence in pulsatile tinnitus: fixed defect or a dynamic process?
This study shows sigmoid plate bone regrowth in most patients after endovascular stenting, supporting a hemodynamic, potentially reversible process.
🔗 Read more: https://t.co/KtoWF7m9L4

[Lorenzo Pinelli @LorenzoPinelli]

Very helpful, thank you @a_charidimou ! 🙏🏼

[Lea Alhilali, MD @teachplaygrub]

1/Controversy in radiology can get tense!

The Mt Fuji sign for tension pnemocephalus is under scrutiny. When should you call it?

A thread about imaging this important neurosurgery complication

[Neurology Journal @GreenJournal]

Teaching NeuroImage: Neuroradiological Aspects of Cerebral Proliferative Angiopathy
https://t.co/7ic2u8JatU

[AshuJadhav @AshuPJadhav]

A route for cerebrospinal fluid flow through leptomeningeal arterial–venous overlaps enables macromolecule and fluid shunting https://t.co/9Wk4gjRFp8

[Dr. Brandon Beaber @Brandon_Beaber]

MRI findings of genetic diseases often misdiagnosed as MS. A-D LHON B CADASIL. D CANVAS. E Krabbe disease F Cobalamin C disease. G polymerase gamma gene disease. H Alexander J/K CADASIL L Spastic paraplegia 5 with diffuse leukoencephalopathy https://t.co/h0aW7Cd4hJ

[INTERNEURONA @interneurona]

🧠 Pacientes >75a con amnesia leve, atrofia hipocampal llamativa pero sin clara progresión cognitiva.

☝️No siempre es Alzheimer.

👉 Podría tratarse de #LATE, una encefalopatía por TDP-43 que simula EA pero sigue otro curso

https://t.co/2ohgL1ZpfL

[Neurochecklists @neurochecklists]

“Lupus Myelitis” Revisited
A Retrospective Single-Center Study of Myelitis Associated With Rheumatologic Disease https://t.co/K11i0HHw3D

[Neurochecklists @neurochecklists]

MOGAD: A comprehensive review of clinicoradiological features, therapy and outcomes in 4699 patients globally
https://t.co/lNTwZ1B7LP

[AJNR @TheAJNR]

"Spontaneous Intracranial Hypotension Associated with Vascular Malformations"

https://t.co/Aqsa1XDwfq

@MarkMamloukMD @williamdillonmd @The_ASSR #CSFLeak

[Lea Alhilali, MD @teachplaygrub]

Can’t remember what to look for on scans for memory loss?

New Alzheimer’s treatments are changing the way we look at these scans!

Read on for w/the latest @theAJNR SCANtastic on imaging for Alzheimer’s:

https://t.co/1mPC273Xrm

Current hypothesis in AD is that amyloid beta (AB) protein results in inflammation & neuronal death. Treatments in AD are focused on anti-AB antibodies to remove this protein

But AB protein is in vessel walls & removing it increases vascular permeability, leading to edema & hemorrhage

On imaging, this causes ARIA (Amyloid Related Imaging Abnormalities), which may be ARIA-E (edema) or ARIA-H (hemorrhage)

Not everyone gets ARIA. So what means a high risk of ARIA?

Before you dive into treatment, you want to know if they will sink or SWIM—so look for SWIM:
S = superficial siderosis (present/absent)
W= white matter hyperintensities (graded mild, moderate, or severe on the Fazekas scale)
I = infarcts (total number)
M = microhemorrhages (total number)

1-4 microhemorrhages = high risk & need repeat imaging
>4 are excluded

Remember the rhyme:
1 to 4 = need to image some more
If there’s 5, treatment won’t jive

ARIA is usually treated by pausing treatment if it’s moderate to severe. So remember this by the rhyme:
--If they start to feel, then it’s a big deal
--If ARIA findings > 5, then medication deprive
--Or if siderosis > 2, then medication break for you!

Hopefully, now you ARIA will stay in your memory!!

[Francesco Sanvito @FraSanvito]

Debate about the clinical application of RANO 2.0. To what extent is it appropriate?

RANO 2.0 application guide for clinical trials:
https://t.co/BWzZ44LXBO

Letter:
https://t.co/l9o8c3mxjk

Reply to the letter:
https://t.co/fhr4ZGoZ51

Opinion article:
https://t.co/0Z6tTKoMZO

[Jae Song @jsongmd]

📣Do more CTA than MR carotid imaging? Need a way to classify carotid plaque using Plaque-RADS on CTA? Read our work evaluating patients w/ ESUS🧠using CTA-based Carotid Plaque-RADS!

@StrokeAHA_ASA @AHAScience @lucasabaITA @PennRadiology @PennNeurology

📖https://t.co/VJCEHwEspm

[Jack Garnham @jjgarnham]

Good example of how thalamic lacunes can be invisible on FLAIR imaging. The right thalamic lacune clearly seen on the T2 is FLAIR occult!

[Marinos Sotiropoulos, MD 🇬🇷🧠 @Marinos_S]

New publication: CHANTER is an under-recognized syndrome of multifocal cerebral edema after opioid ingestion. It's important to recognize: diffusion restriction and edema are reversible and outcomes are promising!
Free copy: https://t.co/g5GBaUm49s
@DanHarrisonMD @BWHNeuroICU

[Lea Alhilali, MD @teachplaygrub]

Have MULTIPLE questions about MULTIPLE sclerosis?

Having trouble seeing neuromyelitis optica?

In a fog about MOG?

Here’s the cheat sheet you NEED to distinguish the demyelinating diseases!

Demyelinating diseases predominantly involve the optic nerves, brain, & spine. 

The three main chronic demyelinating diseases are Multiple sclerosis (most common), neuromyelitis optica (NMO), & myelin oligodendrocyte glycoprotein (MOG) antibody associated disease or MOGAD

Each has its own features in the optic nerve, brain, & spine.  Here’s how to remember them!

MS
Optic nerve:
MS only has 2 letters, so MS involvement of the optic nerve tends to be short segment
Brain:
Letter M makes the shape of the perivascular distribution of lesions along the ventricles (Dawson’s fingers)
Letter S makes the shape of the subcortical U fiber involvement
Spine:
MS is only 2 letters, so lesions are usually less than 2 vertebral bodies in length

NMO
Optic nerve:
NMO is a longer abbreviation, three letters, so longer involvement
NMO can stand for Near My Occiput. Occiput is posterior, so more posterior nerve involvement
Brain:
NMO can stand for Near My Ocean. What is your brain’s ocean? The ventricles. NMO lesions are all periventricular
Spine:
NMO is 3 letters, so lesions usually more than 3 vertebral bodies in length

MOGAD
Optic Nerve:
Remember MO’ GAD-olinium.  So things that cause more regions of enhancement.  MOGAD lesions are commonly bilateral & long segment & enhancement can extend perineural
Brain:
Remember LO’ GAD.  MOGAD typically involves the lower areas of the brain
Spine:
Remember MO’ PLAID. MOGAD can give a plaid-like H shape in the cord from predominantly gray matter involvement

Hopefully, this cheat sheet will help you remember how to distinguish the demyelinating diseases! It ain’t lyin’ about diseases of myelin!

[The Neuroradiologist @theneuroradguy]

Venous epidural hematoms constitute about 25% of epidural hematomas, look like arterial EDHs (lensshaped), but can be found in three very typical locations: the posterior fossa, near the vertex and near the temporal pole #radiology #neuroradiology #RADed #FOAMrad #MEDed #FOAMed