Tips & tricks of DWI to help narrow the differential. Ddx:.Stroke.Abscess.Hypercellular tumor.Hematoma.Epidermoid cyst.Encephalitis.Seizure.Demyelination.Toxic/metabolic disorders.CJD.Other stuff I’m forgetting.#Neurology #neurosurgery #radres #MedTwitter #MedEd @TheASNR

🔷60 y/o F with history of breast cancer presents with altered mental status, ataxia and ophthalmoplegia, what is the most likely diagnosis? . #radres #futureradres #Medicine #MedEd #Neurology #neurosurgery @Radiopaedia @ASHNRSociety @AlbanyMedRadRes #FOAMed #MRI

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For more reading 📖 .

🔷Imaging hints:. ▶️Cortical sulci do not reach the inner table of the skull (yellow arrows) and are partially effaced.▶️Mass effect.▶️Apparent thickened cortex.▶️If contrast was given, displaced cortical veins between the collection and the cortex may be helpful

⭐️ Answer: Isodense right subdural hematoma . 🔷Isodensity typically occurs in the subacute setting between 3-21 days though can rarely be seen in the acute setting if the patient is anemic or if the hematoma is diluted with CSF.

⭐️ Just 2 weeks to go! Register now for the @Radiopaedia 2025 annual conference! 🧠 . 🔷Dates: July 21-25. 🔷Program schedule: 🔷Register: #radres #Medicine #Neurology #neurosurgery #futureradres #MRI #FOAMed #ENT #MedX @TheASNR.

1️⃣ image is all you need, what is the diagnosis in this 50 y/o Male?. #neurosurgery #meded #Medicine #Neurology #radres #futureradres #MRI #CT #FOAMed @AlbanyMedRadRes

For more reading 📖 .

🔷MRI:.▶️Loss of normal black flow voids on T2 (also commonly seen in normal slow flow).▶️Filling defect in vein after contrast admin.▶️Empty delta sign (contrast opacification around the clot). ⭐️Acute clot can also show diffusion restriction and BLOOMING on GRE/SWI 🧠. 💡 Be

💡 Hyperdense sinus >65-70 HU (be aware of pitfalls such as patients hematocrit, recent contrast administration, CT technique). 💡 Newborns may have physiologic polycythemia, relative hypodense parenchyma, and perinatal hemorrhage which can be misinterpreted as sinus thrombosis

🔷Clinical:.1️⃣Headache (most common).2️⃣Focal Neuro deficit.3️⃣Seizures. 🔷IMAGING:.Non con CT: .▶️Tubular hyperdensity representing the occluded vein (seen in acute and subacute setting).▶️Edema and/or hemorrhage.▶️Filling defect in vein after contrast admin.▶️Empty delta sign

🔷Two types of edema can develop:.1️⃣Vasogenic (from venous back pressure).2️⃣Cytotoxic (ischemia). 🔷Risk factors:.💡 Up to 20% are idiopathic.1️⃣Trauma.2️⃣Tumor/malignancy (compression/invasion from meningioma).3️⃣Infection.4️⃣Hormonal (pregnancy).5️⃣Dehydration.

⭐️ Answer: Cortical vein thrombosis (CVT). ▶️CVT causes retrograde venous pressure leading to focal vasogenic edema. ▶️Increased back pressure is characterized by dilated veins and petechial hemorrhage which can progress to large hematomas and ischemic neurological damage.

⭐️ What is the most likely diagnosis in this pregnant patient presenting with seizures? 🧠. #Neurology #medicine #radres #futureradres #Neurosurgery #MRI #FOAMed

RT @CarlosC74716941: @daniel_gewolb @ASHNRSociety @Radiopaedia

💡 Preoperative embolization often necessary to reduce bleeding during surgery. 💡 Make sure to describe full extent of tumor to avoid incomplete surgical resection as well as imply a need for radiation in unresectable cases.

▶️Main Ddx is Rhabdomyosarcoma:. ▶️Rhabdomyosarcoma can arise anywhere though is less likely to invade the pterygopalantine fossa. Rhabdo usually has more bone destruction than remodeling and is usually less avidly enhancing in comparison.

🔷Imaging:. ▶️Markedly enhancing soft tissue mass widening the pterygopalantine fossa with bony remodeling. ▶️Marked enhancement may give a salt and pepper appearance due to internal flow voids. 💡 LOCATION, marked ENHANCEMENT, age and GENDER are 🔑 to the diagnosis

⭐️ Answer: Juvenile Nasopharyngeal Angiofibromas are rare benign (though locally aggressive) tumors that arise from the SPHENOPALATINE FORAMEN. 💡 Classically, they present in adolescence w/ epistaxis almost exclusively in MALES (though I have seen new diagnoses in older patients.

⭐️ Yesterday was the last day of my Neuroradiology fellowship! Huge thank you to @drsuyash @jsongmd @Ali_Nabavizadeh and so many more not on twitter for all the help and support @PennRadiology ! I could not have asked for a better fellowship! Next stop, assistant professor of.