Angel

AUTOANTIBODIES in Rheumatology @RheumOnePagers

NEUROLOGICAL APPROACH TO DIZZINESS Dizziness is one of the most common reasons for a neurology consult. The murky waters of the vestibular system are scary to us mere mortals. But having a framework provides a map to sail these choppy seas! Thread below:

Things to know before calling these consults @DrBrittV

Trying to cover your bases when it comes basal ganglia region anatomy? Need some core knowledge of the corpus striatum? Want to be a boss when it comes to anatomy here? Can you see the Boss Baby w/the puffy cheeks here? Here's how this baby can help you w/this anatomy... Deep brain anatomy in the coronal plane looks like a baby with puffy cheeks. This can help you remember the anatomy & function! Here’s how: ➡️Cingulate gyrus: 🔸Looks like the baby’s hair. It’s a SINGLE tuft of hair for the CINGulate gyrus 🔸Cingulate gyrus is involved in processing painful emotions 🔸Remember: CINGulate is for things that SINGED you ➡️Corpus callosum: 🔸Looks like the evil boss baby eye brows 🔸It’s the crossing fibers so it’s what makes the baby look cross! ➡️Fornix: 🔸Looks like the baby’s nose 🔸Involved in memory 🔸Remember the NOSE KNOWS things and FORnix never FORgets ➡️Corpus striatum: 🔸Looks like the baby puffy cheeks 🔸Made up of many different structures ▶️Putamen: important for motor skills. PUT-amen help you PUT-one foot in front of the other ▶️Striatal bundles: important for learning actions w/a reward. STRIatal bundles make you want STRIVE for better ▶️Caudate: involved in associated learning. CAUdate helps you learn the CAUSES ➡️Claustrum: 🔸Looks like the baby’s ears 🔸Inhibits motor function, esp during sleep 🔸Remember Santa CLAUStrum only comes when we sleep Hopefully now you have a deep knowledge of these deep brain structures!!

1/Correlate clinically! It’s harder than you think in THALAMUS—where its size is small & but the clinical symptoms are large. Here’s a thread to help you remember the main thalamic syndromes & their locations!

One of the most challenging yet essential skills to develop in the practice of medicine is the ability to think The book "How to Think Like a Neurologist" by @emeltzermd does a great job introducing some foundational principles of neurology Here's a summary:

Our chief, Dr. Nakagawa, representing Hawai'i in his discussion on the FOXO3 longevity genotype 🧠 #ISC24

@caseyalbin brains over beans!

#neuronovernephron Always always think about angiography the first time around. No one likes going to the CT scanner twice.

Approach to Interpreting Chest X-Rays

1/If you aren’t cheating, you aren’t trying! Are you looking at MRIs? Feeling some confusion about the diffusion? Feel impaired when it comes to the FLAIR? Wish you could cheat a little? Here’s a little cheat sheet on all the sequences you NEED to know for looking at MRIs! ➡️T1: It’s for anatomy, so brain structures reflect the same color as real life. 🔸So gray matter is gray on T1 & white matter is white on T1. 🔸It’s also for contrast. Contrast is taken up by masses making them light up & easier to see. ➡️T2: It’s the water sensitive sequence. 🔸What is pathologic water in the brain? Edema! 🔸Remember--everything bad in this world is trying to turn you back into what you came from—water! ➡️DWI: Diffusion detects stroke, which are bright on DWI. 🔸But anything that makes space tight in the brain can be bright on diffusion (cellular masses, pus under pressure, etc.) ➡️Gradient: Gradient is sensitive to metals. 🔸What’s the most important metal in body? Iron—bc iron is in blood. 🔸So gradient is our blood sensitive sequence 🌟So remember🌟 ▶️T1 is for Anatomy & Contrast ▶️T2 is for Water & Edema ▶️DWI is for stroke ▶️Gradient is for blood Hopefully, this will help you next time you have an MRI--who says cheaters never win? 😉

Just because it’s called SMALL vessel disease doesn’t mean it doesn’t have a BIG impact! Small vessel disease (SVD) is a BIG contributor to vascular dementia, along w/large vessel cortical infarcts Do YOU know all the faces of small vessel disease? Common imaging markers of SVD include: --White matter hyperintensities (WMHs) --Lacunes --Enlarged perivascular spaces --Microbleeds --Small subcortical infarcts --Brain atrophy But what you see isn’t always what you get! Even in patients w/similar degrees of SVD on imaging, clinical symptoms can be very variable. Variability exists because of: --Perilesional penumbra --Remote effects from disruption of brain connectivity --Differing brain reserve & compensatory mechanisms So remember, imaging findings of SMALL vessel disease are just the tip of a very BIG iceberg

🩸🧠Treatable causes of intracerebral haemorrhage ⭕️ Several macrovascular disorders 🗝️Key features seen on brain MRI and/or CT 💡 Clues for diagnosis via: @DiseasePrimers #neurotwitter #NeuroTwitter #NeuroRad #MedTwitter #MedStudentTwitter #MedEd #EndNeurophobia #Neurology #Neurosurgery #RadEd #stroke #amyloidangiopathy #FOAMncc #WICH2023

1/Does your ability to remember temporal lobe anatomy seem, well, temporary? Are you feeling temporally challenged when it comes to this complex region? Here’s a thread to help you remember the structures of the temporal lobe!

1/Seeing static? This could be visual snow syndrome. Read along this purely educational thread to learn more about this neurological condition! #visualsnowsyndrome #vs #VSS #disabilitytwitter #neurology #neurotwitternetwork #meded #migraine

ENRICH trial. Minimally invasive ICH evac. vs medical treatment. Utility weighted mRS better in surgical group, especially lobar (vs anterior basal ganglia) ich location. Better mortality & LOS with surgery #NCS2023

@HeraKamdar @DianaGCMD beautiful & smart ladies ❤️ 🧠

Amazing as always catching up with one of my favorite neurointensivists and mentors @DianaGCMD! Love the reunions that happen at #NCS2023 🤩

Said every emergency physician and neurologist who has cared for multiple people under age 40 with devastating strokes caused by vertebral artery dissection from rapid neck manipulation by chiropractors.

1/Having trouble remembering what you should look for in vascular dementia on imaging? Almost everyone worked up for #dementia has infarcts. Which ones are important? Here’s THE FULL #tweetorial this time on the key findings in vascular dementia #meded #medtwitter #neurotwitter

#MondayTip #Basilar artery occlusions: ☝️Proximal/mid occlusions: atherothrombotic. Unilateral/crossed pontine syndromes to ‘‘locked-in’’ ☝️Distal occlusions: most cardioembolic. Top of the basilar syndrome (dependins on length and position of the clot and on collateral flow)

Hot off Press: a systematic review with meta-analysis more evidence that tissue clock matters beyond the time clock StrokeAHA_ASA⁩ ⁦@svinsociety⁩ ⁦@MuscNeurology⁩ ⁦@samialkasab⁩ ⁦@E_Almallouhi⁩ ⁦@aboulnourh⁩ jnis.bmj.com/content/early/…