Lea Alhilali, MD
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teachplaygrub.bsky.social
Lea Alhilali, MD
@teachplaygrub.bsky.social
Senior editor American Journal of Neuroradiology; Associate Editor, Radiographics; Associate Editor, Radiology; Deputy Editor, Clinical Neuroimaging.

I try to make learning neuroimaging and neuroanatomy fun. If I can make you laugh, I can help you learn.
Yes!! Great sign!!
January 30, 2025 at 7:39 PM
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3. Inferior, middle, and superior frontal gyri are arranged like a hand fan in the coronal plane above the gyrus rectus & orbital gyrus
 
Now when it comes to coronal anatomy, hopefully you’ve cornered the market!
January 21, 2025 at 4:38 PM
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Only 3 things to remember:

1. Gyrus Rectus is above the nose.  Remember this bc gyrus rectus means straight & it’s straight like your nose is straight!

2. Lateral orbital gyrus is along the medial roof of the, well, as expected, orbit!
January 21, 2025 at 4:38 PM
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So now you know where in the lumbar spine to a look when a patient tells you the pain radiates down their leg!
 
Remember, there are many variations & this is just a starting guide
 
But hopefully now remembering the lumbar radicular distributions won’t be a pain in the backside!
January 16, 2025 at 3:55 PM
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L5
L5 radiates to the big toe.
Remember the little rhyme “Five is to the big guy!”
L5 is also foot drop. Remember big guys are heavy, and heavy gravity = drop.
 
S1
S1 radiates to the side of the foot.
Remember this because both S1 and Side start w/S.
January 16, 2025 at 3:55 PM
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L3
L3 radiates to the knee
Remember L3 is to the knee—easy, it rhymes!
 
L4
L4 radiates to the calf.
Remember this bc the number 4 looks like the calf, Top part of the 4 looking like a bulging gastroc & the bottom part of the four is the rest of the calf connecting to the ankle.
January 16, 2025 at 3:55 PM
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L1
L1 radiates to the groin
Remember that b/c the number 1 is, well, um…phallic. So phallic number 1 radiates to the groin
 
L2
L2 radiates to thigh
Two is the number between 1 & 3, so distribution of L2 is between the distributions of L1 and L3—& between the groin (L1) & knee (L3) is the thigh.
January 16, 2025 at 3:55 PM
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Quadrigeminal cistern
Contains CN4 & pineal gland
Remember bc QUAD is the prefix for FOUR
 
Lamina terminalis:
Contains ACOMM
Remember this bc shape of SAH after ACOMM rupture follows this cistern anteriorly
 
Now when you look at cisternal anatomy, you’ll definitely be able to go w/the flow!
January 13, 2025 at 3:43 PM
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Chiasmatic cistern
Contains CN 2 & pituitary stalk
Easy to remember bc CHIASM is CN 2
 
Interpeduncular cistern:
Contains CN 3 & mammillary bodies
Remember this bc if you lay the number 3 on its side it looks both like the 2 cerebral peduncles (where this cistern lies) & well, 2 mamillary bodies
January 13, 2025 at 3:43 PM
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Cisterna Magna:
Largest cistern
Contains CN 9-11 & vertebrals
Remember: LARGEST cistern contains the LARGEST cranial nerve (vagus) & the 2 CN around it
 
Prepontine cistern:
Contains CN 6 & basilar
Remember this bc the number 6 shape mirrors the anterior pons curvature, where this cistern lies
January 13, 2025 at 3:43 PM
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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!
January 10, 2025 at 3:57 PM
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Common imaging markers of SVD:
 
--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 pts w/similar degrees of SVD, clinical symptoms can be very variable
January 10, 2025 at 3:57 PM