Cervical arterial dissections due to segmental mediolytic arteriopathy
Bibliographic record
Abstract
Spontaneous cervical arterial dissections (sCAD) are a frequent cause of stroke in young patients. However, an understanding of the underlying vascular pathology in these events has been difficult due to the low mortality rate. We present a case of bilateral spontaneous carotid dissections associated with a rare histopathologic diagnosis of segmental mediolytic arteriopathy and review the current literature on this topic. ### Case report. A 53-year-old woman presented acutely with decreased alertness, aphasia, and predominant right-sided weakness. An element of left-sided weakness was also present and her NIH Stroke Scale score was 29. She had no history of trauma and was previously healthy except for headache that initiated 4 weeks prior to presentation. She had a remote smoking history and was on oral contraception but had no other significant vascular risk factors. A CT scan of the brain revealed hyperacute changes consistent with a left middle cerebral artery infarct. CT angiography demonstrated tapering of the cervical carotid arteries bilaterally to near occlusion close to the skull base with wall thickening and the absence of an intraluminal flap (figure, A and B). Occlusion of a distal left …
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".