Free education in a key practice area that is rapidly evolving. Register to get reminded. Thanking our collaborators @WorldFederation and @The_ASPNR from our hearts. Thanking all the amazing teachers who care.

Day 2 at #SPIN25 brings to you problem based learning, but first we get to learn about the range of normality in early life with the phenomenal Prof Gregor Kasparian, coming all the way from Vienna!

#neurotwitter #radres #neurorad #pedsneurorad.

🧠 This week’s SPIN-POV: Multifocal lesions in the cerebrum, cerebellum, brainstem, and deep gray nuclei can be the initial presenting feature of Hemophagocytic Lymphohistiocytosis. Don’t miss it, as early testing, systemic therapy, and HSCT can improve outcomes.

📸 Remember the Spin.If you see:. White matter T2 hyperintensity. Disappearing putamen. Cerebellar atrophy. Think H-ABC and test for TUBB4A.

🧬🔄 DYT4–H-ABC Spectrum.🗣 DYT4 = adult-onset dystonia with normal MRI.🧠 H-ABC = infantile hypomyelination & putaminal atrophy.🎯 Shared link = TUBB4A mutations.🧬 Suggests a spectrum with extrapyramidal symptoms as the unifying core.

🧬 Genotype–Phenotype Correlation. c.745G>A → milder, slower decline. Other mutations → early severe phenotype.🧠 Some show almost complete lack of myelin from the start.📉 Progressive loss of grey matter (putamen → gone).

🧲 Signature MRI Findings.🧠 T2: Persistent hyperintense white matter = hypomyelination.🧠 Vanishing putamen over time.🧠 Cerebellar vermis atrophy.🔍 Thalamus & globus pallidus = preserved

🧠 Clinical Clues.🧒 Onset: infancy (median ~6 months).🎢 Early motor milestones → regression.🎭 Extrapyramidal signs (esp. dystonia, rigidity) = hallmark.🗣 Speech loss, cognitive decline.🧃 Feeding tubes in >50% by adolescence.

🧬 Gene Culprit: TUBB4A.🧪 TUBB4A encodes β-tubulin 4A → key for microtubule stability.🧬 Mutation spectrum includes a dominant c.745G>A variant (most common).🧬 All mutations → de novo (except 1 with maternal mosaicism).

🔬 What is H-ABC?.A neurodegenerative leukodystrophy marked by:. 🧊 Hypomyelination. 🌀 Basal ganglia atrophy (esp. putamen). 🧩 Cerebellar atrophy.📌 Identified by MRI, confirmed genetically.

🎢 Spin Tweetorial Wednesday: H-ABC 🎢.Today’s spin unravels a rare but striking leukoencephalopathy:. 🧠 Hypomyelination with Atrophy of the Basal Ganglia and Cerebellum (H-ABC).Let’s break it down 👇

RT @Amenanayyer: The latest SPIN A Yarn is a special one for those with aspirations. The intelligentsia of pediatric neuroradiology & speak….

RT @The_ASPNR: 🚨 Big news! . The ASPNR is thrilled to co-sponsor the upcoming Whole Body Fetal Imaging Symposium alongside @spinacademics a….

RT @drmankad: It is my humble privilege to bring to you all on behalf of @spinacademics, this free educational study day on fetal imaging,….

RT @The_ASPNR: ✨One hour to go!! Happening soon!✨. International Pediatric Neuroradiology Teaching Network Season VI: Eternal Debates . C….

This week is going to be an absolute watch. Standardized? Detailed? Templates?…. words that imply common sense right, but why is it not then the reality of this world. Did anyone ever teach us “how to report sensibly?” We may get a bit closer to the middle path!.

RT @The_ASPNR: 🔥Less than 24 hours to go! 🔥IPNTN Season VI will feature "Eternal Debates", tackling the most enduring disputes in pediatric….

So much update being provided on this topic by @ajaydsouza, who is not only a subject matter expert, but also our local patron supporting #SPIN25.

This week’s SPIN-POV: LCH remains the most common cause of vertebra plana and multifocal vertebral involvement in children, but always consider TB in endemic regions.This turned out to be spinal TB.While spondylodiscitis and paraspinal abscess favor TB, they aren’t always present