Tim Shepherd

Neuroradiologist

[Tim Shepherd @tim0shepherd]

@NatRevNeurol Previous papers also show spinal cord atrophy before lesions or myelitis - for example;

https://t.co/suTDMnY56H

[Tim Shepherd @tim0shepherd]

@ecalabr Much of movement disorders imaging is great for board exams but worthless IRL

[Tim Shepherd @tim0shepherd]

@jasondruzgal If time commitment is the same either way… I’d actually rather do LPs than read CTAs any day. The decision fatigue accumulation and tedium is far less?

[Tim Shepherd @tim0shepherd]

@jdpereira @portokalh I’m a huge fan of the Haines book or Warner Atlas of Neurosnatomy - the latter was a character and the book is not easy but image quality and the perspectives from the slice orientations can be inspired in the pre-3D MRI era (where you only got one shot at cutting it right)

[Tim Shepherd @tim0shepherd]

@Miriam_Peckham Could also be a rugby player?

[Tim Shepherd @tim0shepherd]

@seraj25 @teachplaygrub We use this to predict the fMRI…. In the sagittal plane divide the medial frontal gyrus (better name for structure above above cingulate gyrus) by the anterior commissural plane - the motor SMA is 1-cm behind it, the language SMA will be 1-cm in front of it.

[Tim Shepherd @tim0shepherd]

@portokalh @northernthrux @nastasiayendiki No real idea - avoided that prep back in the day for this reason - you basically need to gently rehydrate the tissue but this is often what happens during the staining process in some instances so maybe look to that? Don’t start with a previous sample ;)

[Tim Shepherd @tim0shepherd]

@BrentWeinberg I used to give them my baseball card profiling my idiosyncrasies (eg think Hemingway, not Faulkner… don’t say flow voids are normal in 5-mm axial T2 etc)

[Tim Shepherd @tim0shepherd]

@jasondruzgal I would clarify - Friday 507pm when you’re on call, everyone has left and the ED doesn’t stop while PACs is down.

[Tim Shepherd @tim0shepherd]

@PhilipRChapman1 @Miriam_Peckham Not enough rads/fluoro time to do them all, but we’re in a doom loop of non-rad MDs losing skill - alternate fixes… 1) most kits have 3.5” cutting needles that are 1” too short for many USA patients especially for 2) train non rads to use paramedian approach

[Tim Shepherd @tim0shepherd]

@francisdeng Lawyers will always find an expert… some cancer protocols use NECT or CECT in path dependent way - the key original clinical trial used it for decision making etc.

[Tim Shepherd @tim0shepherd]

@EMiddlebrooksMD @TheSENRS Two of my favorite guys - congrats on successful meeting!

[Tim Shepherd @tim0shepherd]

@dyousem1 @TheASNR @radresidents The sweetest part will be in a year … when you get more unsolicited email invites from the “association of functional kidney practitioners” citing this paper.

[Tim Shepherd @tim0shepherd]

@heacockmd You have to be proven amyloid positive by pet or csf to get lecanemab.

[Tim Shepherd @tim0shepherd]

We’ve done more clinical Amyloid PET in past 2 weeks than last 2 years…

[Tim Shepherd @tim0shepherd]

@heacockmd CMS change for sure

[Tim Shepherd @tim0shepherd]

@AdiG1993 @PhilipRChapman1 Referral to correct specialists, avoid repetitive wrong workup/treatment, counseling of patient and family, enrollment in therapeutic drug trials….

[Tim Shepherd @tim0shepherd]

@hsairmd Show-off ;)

[Tim Shepherd @tim0shepherd]

@Avkaji @jasondruzgal @drmankad Brain parenchyma appears normal without hemorrhage, extra-axial collections, hydrocephalus, mass effect or CT signs of ischemia/infarct.

The visualized soft tissues and bones of the skull and face appear normal.

30 words before the wrapper …