Answers
Case 1 - Spinal cord AVM
Singh B, Behari S, Jaiswal AK, et al. Spinal arteriovenous malformations: Is surgery indicated? Asian Journal of Neurosurgery. 2016 Apr-Jun;11(2):134-142. DOI: 10.4103/1793-5482.177663.
Available from: https://www.asianjns.org/text.asp?2016/11/2/134/177663
Case 2 - Spinal dural AVF
Jeng, Y., Chen, D. Y., Hsu, H. L., Huang, Y. L., Chen, C. J., & Tseng, Y. C. (2015). Spinal Dural Arteriovenous Fistula: Imaging Features and Its Mimics. Korean journal of radiology, 16(5), 1119–1131. https://doi.org/10.3348/kjr.2015.16.5.1119
Case 3 - Spinal dural AVF
Spinal Dural Arteriovenous Fistulas. T. Krings and S. Geibprasert. American Journal of Neuroradiology April 2009, 30 (4) 639-648; DOI: https://doi.org/10.3174/ajnr.A1485
Case 4 - venous angioma + cavernous angioma (which then presents with acute bleed)
Idiculla P, S, Gurala D, Philipose J, Rajdev K, Patibandla P: Cerebral Cavernous Malformations, Developmental Venous Anomaly, and Its Coexistence: A Review. Eur Neurol 2020;83:360-368.
Case 5 - parenchyma AVM (presenting with acute bleed), also obstructive hydrocephalus
Radiologic Assessment of Brain Arteriovenous Malformations: What Clinicians Need to Know
Sasikhan Geibprasert, Sirintara Pongpech, Pakorn Jiarakongmun, Manohar M. Shroff, Derek C. Armstrong, and Timo Krings. RadioGraphics 2010 30:2, 483-501
Contemporary Imaging of Cerebral Arteriovenous Malformations
Eric Tranvinh, Jeremy J. Heit, Lotfi Hacein-Bey, James Provenzale, and Max Wintermark
American Journal of Roentgenology 2017 208:6, 1320-1330
Case 6 - Extensive acute left MCA territorial infarct, with haemorrhagic conversion, midline shift to right, subfalcine and uncal herniation; on background of earlier, and smaller MCA infarct, see also old cerebellar infarct. There are several learning points. Differentiating acute from old infarcts, in same territory, over time; identifying haemorrhagic transformation, and mass effect - https://radiopaedia.org/articles/intracranial-mass-effect-summary; https://radiologykey.com/analysis-of-mass-effect/; https://www.radiologymasterclass.co.uk/tutorials/ct/ct_acute_brain/ct_brain_mass_effect;
Lin, M. P., & Liebeskind, D. S. (2016). Imaging of Ischemic Stroke. Continuum (Minneapolis, Minn.), 22(5, Neuroimaging), 1399–1423. https://doi.org/10.1212/CON.0000000000000376
Do compare and contrast (side by side, at the same time) between Case 6, 7 and 8
Notice the small (deliberate) text (spelling) differences between each screenshot
Case 7 - Meningioma - https://radiopaedia.org/articles/meningioma (pay attention to spectrum of histological subtypes, reflected in typical to atypical radiology presentations); Typical, atypical, and misleading features in meningioma. M P Buetow, P C Buetow, and J G Smirniotopoulos. RadioGraphics 1991 11:6, 1087-1106 https://pubs.rsna.org/doi/10.1148/radiographics.11.6.1749851
Use similar search 'key word(s) for Google text, and image search. As part of the process of developing "digital literacy", I would like you all to develop deeper insights into not only why certain online resources appear on the "first page" of an online search (more later), but to also develop a deeper understanding of the use of "key words", and appreciation of "quality online resources", and improve your judgement and skill in assessing these online resources - as relevant, useful and of value.
Toh CH, Castillo M, Wong AM, Wei KC, Wong HF, Ng SH, Wan YL. Differentiation between classic and atypical meningiomas with use of diffusion tensor imaging. AJNR Am J Neuroradiol. 2008 Oct;29(9):1630-5. doi: 10.3174/ajnr.A1170. Epub 2008 Jun 26. PMID: 18583409.
Case 8 - Arachnoid Cyst - https://radiopaedia.org/articles/arachnoid-cyst (start with key radiology features on CT and MRI); https://radiologykey.com/17-arachnoid-cysts/
Mastery Training and Deliberate Practice
'By reviewing research on medical performance and education, the author describes evidence for these representations and their development within the expert- performance framework. He uses the research to generate suggestions for improved training of medical students and professionals. Two strategies— designing learning environments with libraries of cases and creating opportunities for individualized teacher-guided training—should enable motivated individuals to acquire a full set of refined mental representations. Providing the right resources to support the expert- performance approach will allow such individuals to become self-regulated learners—that is, members of the medical community who have the tools to improve their own and their team members’ performances throughout their entire professional careers.'
above quoted from abstract of
Ericsson KA. Acquisition and maintenance of medical expertise: a perspective from the expert-performance approach with deliberate practice. Acad Med. 2015 Nov;90(11):1471-86. doi:10.1097/ACM.0000000000000939. PubMed PMID: 26375267.
Learning Science
1. Use textbooks and a wide variety of online resources to improve your diagnostic and interpretative skills. Practice, practice, practice with reflection and feedback, using a range of resources, to increase your exposure to the variety and spectrum of clinical and imaging findings, both normal and abnormal, from typical, to less common and atypical (as you progress to increase your experience and mastery of clinical practice, and improve your knowledge and skills from undergraduate, through postgraduate to continuing professional development and lifelong learning settings).
2. Compare and contrast is one of the simplest and most effective methods to learn to recognise and differentiate between normal and abnormal XRs and scans. Review a series of normal XRs and scans, and then do side by side comparison between examples of normal, normal and abnormal, and examples of abnormal XRs and scans.
https://effectiviology.com/interleaving/ (mixed practice or interleaving superior to blocked practice)
and
AI
https://news.nus.edu.sg/nus-business-launches-new-centre-to-promote-human-centred-mindset-in-ai-use/
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