Orbital mass on MRI. Lymphoid tissue isn’t just in lymph nodes — it’s in mucosa, GI tract, and even the orbits. 👉 Enter primary orbital lymphoma (~50% of adult orbital malignancies). 📌 Clinical: • Proptosis (obvious here) • Diplopia if EOMs compressed • ↓ Vision if optic

Alright guys, bearings straight. MRI FLAIR: gray matter = white, white matter = dark, CSF = black. First 2 images → 30yo w/ headache. Pretty normal. Last 2 images → 75yo male, decades of HTN + DM, diabetic neuropathy (lyrica, lipitor, metformin, glipizide, multiple BP meds).

excellent!

There is an absent flow-void in the right transverse sinus (arrow), absent of part of the right transverse sinus on MRV, it's normal on the left. This is be a hypoplastic trasnverse (normal variant) or may suggest transverse venous stenosis or thrombosis. Tinnitus is a common

CSF leak is a strong possibility as well. Does the headache worsen when the person stands or improves? If it worsens open standing, it may be intracranial hypotension causing headache and secondary to CSF leak (fixed with a blood patch). If headache worsens when lying down, worse

Nice work!

After today’s Space with camjenglish and thereal_truther, I’m reposting my belief bundling thread. You can be pro-vax and still acknowledge mistakes that eroded trust. You can recognize flawed nutrition science and still believe statins or GLP-1s have a role. Don’t cluster

Thank you so much for your response, fellow physician Tom Chen, MD

Bulging eyes = proptosis. Most common cause? Thyroid-associated orbitopathy (Graves’). 💡 Board pearl: Treating hyperthyroidism doesn’t prevent orbitopathy. Why? Antibodies attack orbital fibroblasts → GAG deposition, fibrosis, fat expansion → muscle belly enlargement (tendon

This is an acute intracranial hemorrhage in the basal ganglia — a common location for hemorrhage due to high blood pressure (hypertension). Symptoms? •Headache •Significant weakness in the right upper & lower extremity •Dysarthria and facial droop Why? The blood sits next to

This is an acute intracranial hemorrhage in the basal ganglia — a common location for hemorrhage due to high blood pressure (hypertension). Symptoms? •Headache •Significant weakness in the right upper & lower extremity •Dysarthria and facial droop Why? The blood sits next to

1️⃣ Case & Imaging A 45-year-old smoker with longstanding Graves’ disease presents with proptosis & blurry vision (VA 20/100 OU). MRI orbits (coronal & axial) 👇👇 show marked enlargement of the extraocular muscles (pics 1 & 2). Contrast with normal (pics 3 & 4). 2️⃣ Teaching

I started tweeting in April 2025 with one goal: stay evidence-based and speak the language of science. Some of my positions are unorthodox, challenging entrenched nutrition paradigms and outdated dogma. And I’ve noticed a pattern: when the discussion is kept to data and

Thanks! I’ll be sharing more neuroradiology cases, and the next step will be short video explanations. Stay tuned — lots more to learn together.

Does this patient have a history of autoimmune disease? Reflexively, I want to say meningioma. But note the enlargement of the contralateral lateral rectus muscle (green arrow, left). This diffuse involvement, with possible myositis of the lateral rectus, raises concern for

Great job Tim. Keep it going 💪.

There is nothing wrong in teaching your son conflict resolution. It worked out well for the boy — he saw you don’t have to drag yourself in the mud with someone to be a victor in life. That dad’s ego was smaller than his insight. He turned it into a teachable moment. The boy

🧠 MRI T2 (fat suppression) Do you see the optic nerve & its sheath? 👉 Zoom-in (green arrow, 2nd image) highlights both. Two key concepts for radiologists, neurologists & neurosurgeons: 1. Optic nerve = white matter tract On T2: Gray matter = lighter White matter = darker The