This the real truama. It is a pencil, going through the eyeb | Figure 1

Dr_IlkinBakirli
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Surgery Resident

This the real trauma. It is a pencil, going through the eyeball, through the supraorbital foramen and into the brain. It is not so easy to detect this on the imaging methods, but of course if you'd look at the patient physically, you would see a pencil in their eye. I found this interesting and quite really basic, but yet very difficult to diagnose just with this picture. The second picture is after the surgery. The pencil was removed and very little brain damage was caused. #neurology #head #brain #eye #Ophthalmology #Trauma

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When reading EEGs....
Sometimes we will find those suspicious looking waves on FP1/Fp2....If you are in the neuro club and learning EEGs like me, you would jump to apply the 6 rules to determine if this wave is epileptogenic or not (see another post with my summary).
But in this case, the next logical step to do, is to change it to reference montage (see 1st and 2nd pic).
The idea is, if that suspicious wave you saw on FP1/Fp2 is indeed from the brain, given it's big and of clear different frequency, then it has to have certain field to it, aka, the contigous lead has to "capture some spread" from that activity. If no field, then likely not coming from the brain (since they are the frontopolar leads, likely coming from eye movements/flutter).
I posted 1 single wave like this, and then on average you can see it's only on that lead, without any field at all to the contiguous leads. hence eye blink artifact.
Now, on the 3rd and 4th picture, you can see this can go crazy and if we are not careful we can easily think this is epileptogenic activity, but no, it's coming from eye movements, not from electrical dysfunction of the brain :)
#loveneurology

pre-op CT. Pencil still in place. Suffered CSF leak from eye.

3 eyes: normal, brain death and psychiatric. What can we tell from these images and what do the eyes foretell? All three are patients with different pathologies. What do you see when you look into a patient's eyes? The last image accompanies an essay on mental illness, "Hotel California" link in bio.

gun shot wound from forehead through left eye that destroyed the eye. Notice the disorganized scleral/uveal/corneal contents (Sagittal CT FACE shows this well too). Had to do a primary enucleation and close the socket to prevent spread of infection to the brain (there was a frontal wall fracture with pneumocephalus...).

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He had a history of hypertension, long-term smoking, and a sedentary lifestyle.
On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

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A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?