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🤷‍♂️ Why care about Anterior Atlanto-Occipital Membrane (AAOM) tears? ✅ Routinely visible on #MRI ✅ Tears in 3️⃣ distinct patterns ✅ Presents w/ CCJ prevertebral effusion on #CT & major CCJ lig. injuries on #MRI ➡️ rdcu.be/dawhs #NeuroRad #NeuroSurgery #Spine

📢 Honored to share our latest #Research endeavor on this often overlooked #Ligament in the upper cervical #Spine. Upper prevertebral effusion on #CT = great predictor of AAOMc injury & internal #CCJ derangement in high velocity #Trauma! #Radiology #RadRes #Neurosurgery #Spine

💁‍♂️ Friendly #RadRes reminder ➡️ BDI widening is unreliable in determining #craniocervical dissociation. For some reason, this measurement is the one residents always rememeber. Just a plain film hangover! 😉 #NeuroRad #Radiology #MedEd

Hx: High velocity MVC #trauma. ➡️ Cervical #MRI: An apical ligament tear & craniocervical injury on the sag. STIR 🤔? ✅ Nope, just a normal venous plexus & a negative MRI. #RadRes #NeuroRad #Spine

Juvenile nasopharyngeal angiofibromas are rare, but are often a board favorite. They are vascular tumors that occur almost exclusively in adolescent males & present with nasal obstruction or epistaxis. Treatment includes endovascular embolization followed by surgical resection.

#RadRes: Anterior osteophyte fx. can be tricky in a degenerative spine: ⤵️ Left = acute Right = chronic ✅ Prevertebral effusion & absent cortication along the "lucency" although are super helpful... #NeuroRad #Trauma #Spine

🔑 Tectorial membrane interdigitates w/ & forms the dural plane between the retroclival epidural & subdural compartments in peds patients: ✅ Epidural = more common in MVA trauma (sign of CCJ derangement!) ✅ Subdural = more common in Non accidental trauma. #RadRes #NeuroRad

"Numb chin syndrome" , or mental nerve neuropathy, refers to unilateral or bilateral numbness of the lower lip and chin in distribution of the mental or inferior alveolar nerves. It can have a variety of causes. Vaso-occlusion in the maxillofacial region of sickle cell patients

#RadRes 📚 Central C2 osteochondrosal injury on #MRI in a 5 y/o ⤵️ ✅ Anterior angulation of the dens. ✅ C2 Synchondrosal fluid. ✅ Posterior AO membrane complex injury (low grade) #NeuroRad #Spine #Trauma

Nice depiction of C2 synchondroses in a 2 y/o 😎 (with adult C2 vertebrae for comparison): ⤵️ ✅ Note the "absent" os odontoideum (which hasn't yet ossified) but w/ the apicodental synchondrosis present. #RadRes #NeuroRad #Spine #MedEd

Great work by our #radiology residents UF Jax Radiology Residency in their latest publication on a subtle C2 traumatic injury in the #pediatric population. #RadRes #NeuroRad #Spine #Trauma C2 Synchondrosal Injuries: A Case Report and Anatomic Review cureus.com/articles/17694…

The pleasure was all mine! x.com/CharityH4TW/st…

#RadRes: Can we discuss #craniocervical trauma? Me: Absolutely! Lets start here... #NeuroRad #Spine

Hx: "seizures" Looks up vitals: SBP 220 Dx: HBE (Hypertensive Brainstem Encephalopathy) ➡️ Pontine predominant variant of "PRES" No differential diagnosis needed! 😉

CT: "Normal" atlanto-occipital joint space. MRI: Unstable craniocervical dissociation injury (same pt.) 🔑: Don't solely rely on the joint space or "lines" to exclude CCJ trauma. Exclude 1. Prevertebral 2. Supradental 3. Retroclival hematomas too!

Rule of thumb for detecting M2 MCA vessel occlusion on CTA: ⤵️ ✅ Superior M2 division = territory predominantly ant. to sylvian fissure. ✅ Inferior M2 division = territory predominantly post. to sylvian fissure. Real time saver on those busy call nights 😉!

📢 Not sure who still needs to hear this... But this imaging finding is NEVER (like not ever!) a sign of dural sinus thrombosis (Don't even entertain it! 🤫) Dx: Incidental arachnoid granulation (Image courtesy of Radiopedia)

Cerebellar vascular territories 🧠 ⤵️ Tentorial surface (red) ➡️ Superior cerebellar a. Occipital surface (blue) ➡️ Posterior inferior cerebellar a. Petrosal surface (pink) ➡️ Anterior inferior cerebellar a.

Actual Hx: "Internuclear Opthalmoplegia (INO)" 😯 🧠 MRI = small right MLF stroke. (Disrupts CN VI nuclei via PPRF ➡️ weakens ipsilateral eye adduction, but preserves contralateral eye abduction.) Shout out to this awesome neurology resident for making my job easy! 😎

INO can of course be bilateral too! Hx: "Discordant gaze & multiple sclerosis (MS)" 🧠 MRI ➡️ MS plaque in dorsal pons affecting Bilateral MLF (Lack of convergence in horizontal plane causing a characteristic divergence) Aka: "Wall-eyed" 😳