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@@reyazuljanat9936 he's my son, Im not thát old ;). Ill be sure to tell him, thanks!

@theneuroradiologist sorry my bad, actually I perceived at the end of lecture as if you told that your grandson told, like n subscribe; Anyways my apologies again, by the way your Son is cute🙏

@reyazuljanat9936 no worries, no offense was taken ;)

I' feel for you, but I'm afraid I can't help you. Pineal gland cysts are very prevalant in the general population, and are asymptomatic and incidental findings in the large majority of people who have them. Rarely do they cause symptoms by leading to hydrocephalus, which would be a surgical indication. The question of whether or not there is a relationship between your pineal gland cyst and your complaints is not an easy one. There are some schools that believe that (larger) pineal gland cysts can cause symptoms due to venous compression, but not everyone agreees. If your cyst is a small one (< 10 mm) it is unlikely to cause symptoms and is most likely incidental. If it is larger it is still not necessary the cause of your symptoms. Surgery is not without risk and although there are stome studies out there on the subject, symptom improvement is not guaranteed or might be due to placebo effect. I'm not a neurologists nor am I a neurosurgeon. Furthermore, it is hard for me to have an opinion on your case as I haven't seen your images. I feel for you, and the best advice I can give you would be to have your case re-examined by getting a second opinion from another neurologist or neurosurgeon. Wishing you all the best, Sven.

@@1331reza not yet, its on the to do list!

Thanks, I'll be sure to tell them ;)

Sure, check out my playlist on pediatric neuroradiology

@@radgirl5187 good luck with your exams!

😆 I'm Belgian

Working on somethjng...

You're welcome, seito!

Hello, Sven here, too lazy to switch accounts. Thanks for your nice comment! To be honest, I learned most from pictorial reviews from journals like Radiographics and Insights into Imaging. They have articles on almost any theme possible, richly illustrated and well witten... I think I read entire volumes of Radiographics as a radiologist-in-training. My tip for you would be is to look up one or more review articles each time youre confronted with a case that confronts you with the limits of your expertise. Also: make your own presentations! The best way to learn something is by teaching it!

@@ajazmalik580 ok, dont know if these are the best books for learning, but this is one of my favorites: "Brain Imaging with MRI and CT" by Zoran Rumboldt, although the approach is I believe not ideal for "learning" neuroradiology

@@ajazmalik580 and also google: "Advanced Neuroradiology Cases", although that is admittedly not a starters book :D, but its one of my favs

@@21231770 thanks for pointing that out. I"d love to say I put that in there deliberately to see if anyone was actually still watching that far into the video, but Id be lying :D

Not an easy question to answer. Over the years a lot of different authors have used different perfusion parameters as correlate for core respectively penumbra. Look up an excellent review on perfusion CT by Jelle Demeestere published in Stroke in 2021 (I think) for an overview. Thing is, earlier studies found absolute CBV values the best parameter for identifying core (and also easy for a visual evaluation), but later studies found relative CBF values < 30% to be the best correlatie, and thats what the RAPID software uses / is based on.

So its not as easy as "cbf low = hypoperfusion" and "cbv low = infarction". That's a simplification, but that approach works in extreme situations (large cores or large penumbras) in a pure visual approach. For quantitative software, using Tmax > 6 sec and rCBF<30% works offers a more accurate depiction of hypoperfusion and core.

@@theneuroradiologist that makes a lot of sense! Thanks for your explanation. Really helpful videos for a radiology resident

yes, that's correct, did I err in the presentation? If so, could you point out the time point to me, I'll try to correct it

1:12:11

@@sivasidhanth3203 I see what you mean, the point is that calcifications often look "burst" towards the periphery of the tumor in primary pineal gland tumors, while in germ cells tumors they tend to remain localized and are often engulfed by the tumor. In the case you see there it's a germ cell tumor with an excentrically located clump of calcifications, it is not completely engulfed, but nothing is 100% in radiology. The calcifications are definitely not "burst" or "scattered" to the peripherey, as we see on that slide in the patient with pineoblastoma so it's still a more typical pattern for germ cell tumors.

Oh okay sir, got it! Thank you😊

Thank you very much, Felice!