MRI revealed a small mass lesion in left cingulate gyrusposteriorly.
Value your expert opinion.
Thanking you in advance.
Regards
Sanjeewa
#yiv7288845867 P {margin-top:0;margin-bottom:0;}Hello,
Dr. Tirman answered class IV vs class V injury of lingual nerve, which is great as this kind of imaging is not done everywhere.
Here’s the complete ans..
Case 1- class V lingualCase 2- class IV lingualCase 3- class III long buccal nerve
The expert surgeon based on the clinical exam and neurosensory testing expected class IV in all three nerves but correctly identified clinically, the particular nerve which was injured.
Two of them have tongue atrophy clinically – case 1 and 2.
Chance of recovery with class 4/5-poor to none without surgery
Class 3- partial recovery but since there is persistent pain- will undergo neurolysis surgery of LBN.
Best!AC
Avneesh Chhabra, M.D. M.B.A.
Professor Radiology & Orthopedic Surgery
Chief, Division of Musculoskeletal Radiology
UT Southwestern Medical Center, Dallas, Tx
5373 Harry Hines Blvd.
Dallas, Tx-75390-9178
Hello
It finally snowed in Tx today-1st for the season!!
I read three today- molar tooth extraction related nerve injuries
ps the three snapshots..
Quiz-which nerve is injured in 1.2.3 pics? and what’s the Sunderland class of Injury?
All three patients badly symptomatic- cant eat- poor QOL
For dental surgery- chose your dentist wisely!
Best!AC
Thanks.I have already told him to get a CT scan done. Will let you know the findings.RegardsSanjeewa
Sent from Yahoo Mail for iPad
I don’t favor DNET
Ganglioglioma good for d/dx. Is CT avail? Ca++ or hem.
If it is a glioma, not a typical low grade astrocytoma. Doesn’t quite look like a (rare) supratentorial JPA, and he’s 35….So anaplastic astrocytoma (grade II-III) considerations
Any demographics that might warrant non-neoplastic considerations?
Blake A. Johnson, MD, FACR
Medical Director, MSCPA
5775 Wayzata Blvd. Suite 190
St. Louis Park, MN 55416
P: 952.738.4623
Sent: Sunday, February 20, 2022 9:16 AM
CAUTION: This email originated from outside of the RAYUS Radiology network. Please follow RAYUS Radiology’s phishing training and guidance. Do not click links, open attachments, or follow demands/requests that appear suspicious. If you would like to report or if you have any questions about an email’s validity, please forward it to Phishing-Report or contact Enterprise Support.
Dear all,
35 years old male, investigating for head ache.
MRI revealed a small mass lesion in left cingulate gyrus posteriorly.
Value your expert opinion.
Thanking you in advance.
Regards
Sanjeewa
Hello,
Dr. Tirman answered class IV vs class V injury of lingual nerve, which is great as this kind of imaging is not done everywhere.
Here’s the complete ans..
Case 1- class V lingual
Case 2- class IV lingual
Case 3- class III long buccal nerve
-all three nerves injured in isolation with other nerves in the vicinity incl. inferior alv nerve being normal.
The expert surgeon based on the clinical exam and neurosensory testing expected class IV in all three nerves but correctly identified clinically, the particular nerve which was injured.
Two of them have tongue atrophy clinically – case 1 and 2.
Chance of recovery with class 4/5-poor to none without surgery
Class 3- partial recovery but since there is persistent pain- will undergo neurolysis surgery of LBN.
35 years old male, investigating for head ache.
MRI revealed a small mass lesion in left cingulate gyrusposteriorly.
Value your expert opinion.
Thanking you in advance.
Regards
Sanjeewa
#yiv7288845867 P {margin-top:0;margin-bottom:0;}Hello,
Dr. Tirman answered class IV vs class V injury of lingual nerve, which is great as this kind of imaging is not done everywhere.
Here’s the complete ans..
Case 1- class V lingualCase 2- class IV lingualCase 3- class III long buccal nerve
The expert surgeon based on the clinical exam and neurosensory testing expected class IV in all three nerves but correctly identified clinically, the particular nerve which was injured.
Two of them have tongue atrophy clinically – case 1 and 2.
Chance of recovery with class 4/5-poor to none without surgery
Class 3- partial recovery but since there is persistent pain- will undergo neurolysis surgery of LBN.
Best!AC
Avneesh Chhabra, M.D. M.B.A.
Professor Radiology & Orthopedic Surgery
Chief, Division of Musculoskeletal Radiology
UT Southwestern Medical Center, Dallas, Tx
5373 Harry Hines Blvd.
Dallas, Tx-75390-9178
Office: 214-648-2122
avneesh.chhabra@utsouthwestern.edu
Sent: Thursday, February 3, 2022 8:05 PM
EXTERNAL MAIL
Hello
It finally snowed in Tx today-1st for the season!!
I read three today- molar tooth extraction related nerve injuries
ps the three snapshots..
Quiz-which nerve is injured in 1.2.3 pics? and what’s the Sunderland class of Injury?
All three patients badly symptomatic- cant eat- poor QOL
For dental surgery- chose your dentist wisely!
Best!AC
Best!
AC
Avneesh Chhabra, M.D. M.B.A.
Professor, Radiology & Orthopedic Surgery
Chief, Musculoskeletal Radiology
Department of Radiology
5323 Harry Hines, Blvd. Dallas, Tx-75390-9316
Office: 214-648-2122
http://www.utsouthwestern.edu/radiology
|
UT Southwestern
|
|
Medical Center
|
| |
|
The future of medicine, today.
|
[gallery]
Sent from Yahoo Mail for iPad
I don’t favor DNET
Ganglioglioma good for d/dx. Is CT avail? Ca++ or hem.
If it is a glioma, not a typical low grade astrocytoma. Doesn’t quite look like a (rare) supratentorial JPA, and he’s 35….So anaplastic astrocytoma (grade II-III) considerations
Any demographics that might warrant non-neoplastic considerations?
Blake A. Johnson, MD, FACR
Medical Director, MSCPA
5775 Wayzata Blvd. Suite 190
St. Louis Park, MN 55416
P: 952.738.4623
Sent: Sunday, February 20, 2022 9:16 AM
CAUTION: This email originated from outside of the RAYUS Radiology network. Please follow RAYUS Radiology’s phishing training and guidance. Do not click links, open attachments, or follow demands/requests that appear suspicious. If you would like to report or if you have any questions about an email’s validity, please forward it to Phishing-Report or contact Enterprise Support.
Dear all,
35 years old male, investigating for head ache.
MRI revealed a small mass lesion in left cingulate gyrus posteriorly.
Value your expert opinion.
Thanking you in advance.
Regards
Sanjeewa
Hello,
Dr. Tirman answered class IV vs class V injury of lingual nerve, which is great as this kind of imaging is not done everywhere.
Here’s the complete ans..
Case 1- class V lingual
Case 2- class IV lingual
Case 3- class III long buccal nerve
-all three nerves injured in isolation with other nerves in the vicinity incl. inferior alv nerve being normal.
The expert surgeon based on the clinical exam and neurosensory testing expected class IV in all three nerves but correctly identified clinically, the particular nerve which was injured.
Two of them have tongue atrophy clinically – case 1 and 2.
Chance of recovery with class 4/5-poor to none without surgery
Class 3- partial recovery but since there is persistent pain- will undergo neurolysis surgery of LBN.
Best!
AC
Avneesh Chhabra, M.D. M.B.A.
Professor Radiology & Orthopedic Surgery
Chief, Division of Musculoskeletal Radiology
UT Southwestern Medical Center, Dallas, Tx
5373 Harry Hines Blvd.
Dallas, Tx-75390-9178
Office: 214-648-2122
avneesh.chhabra@utsouthwestern.edu
Sent: Thursday, February 3, 2022 8:05 PM
EXTERNAL MAIL
Hello
It finally snowed in Tx today-1st for the season!!
I read three today- molar tooth extraction related nerve injuries
ps the three snapshots..
Quiz-
which nerve is injured in
1.2.3 pics? and what’s the Sunderland class of Injury?
All three patients badly symptomatic- cant eat- poor QOL
For dental surgery- chose your dentist wisely!
Best!
AC
Best!
AC
Avneesh Chhabra, M.D. M.B.A.
Professor, Radiology & Orthopedic Surgery
Chief, Musculoskeletal Radiology
Department of Radiology
5323 Harry Hines, Blvd. Dallas, Tx-75390-9316
Office: 214-648-2122
http://www.utsouthwestern.edu/radiology
|
UT Southwestern
|
|
Medical Center
|
| |
|
The future of medicine, today.
|
[gallery]