A Case of Stroke and Blindness
Bibliographic record
Abstract
HistoryAn 82-year-old woman presented to the emergency department with a one-day history of vomiting and vertigo.She did not have a headache, neck pain or history of recent trauma.She reported jaw pain two months prior to presentation, which had spontaneously resolved.Her past medical history included type 2 diabetes mellitus, hypothyroidism, and hypercholesterolemia.She was taking metformin 500 mg twice daily, levothyroxine 25 mcg daily, simvastatin 40 mg daily and acetylsalicylic acid (ASA) 81 mg daily.She was a lifelong non-smoker. Physical ExaminationOn examination, she had right-beating nystagmus on right gaze.Power was normal with the exception of grade 4/5 strength in her left deltoid.There was finger-to-nose dysmetria on the left side, dysdiadochokinesia with the left hand, and an unsteady gait.The remainder of her physical exam was unremarkable. NEURORADIOLOGY: DR. LEEMagnetic resonance imaging (MRI) demonstrated bilateral posterior inferior cerebellar artery distribution infarcts (larger on the left) with diffusion restriction, as well as two small right pontine perforator infarcts.The 3D phase contrast magnetic resonance angiography (MRA) showed absence of identifiable flow in both distal vertebral arteries, and T2 MRI showed an absence of intradural flow void in the left vertebral artery (Figure 1).Digital subtraction angiography (DSA) was not performed, considering the patient's age and the presence of a stroke.Collateral circulation to the basilar and vertebral arteries was presumed to be from both posterior communicating arteries, which were of reasonable calibre. CASE PRESENTATION: DR. MATTIAThe patient was admitted to hospital.Aspirin was discontinued, and she was started on clopidogrel (75mg daily).Investigations did not reveal a cardiac source for her stroke.
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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 | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.001 | 0.002 |
| Bibliometrics | 0.005 | 0.004 |
| Science and technology studies | 0.009 | 0.003 |
| Scholarly communication | 0.004 | 0.003 |
| Open science | 0.002 | 0.004 |
| Research integrity | 0.010 | 0.006 |
| Insufficient payload (model declined to judge) | 0.004 | 0.002 |
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".