Bilateral sixth nerve palsies from carotid cavernous fistulas with transient worsening following transvenous embolisation
Bibliographic record
Abstract
A 59-year-old man presented with a 2-week history of binocular horizontal diplopia worse when looking to the left. He was diagnosed with a left sixth nerve palsy (6 NP) and had new bilateral findings at a 2-week follow-up with new dilated episcleral blood vessels. Bilateral carotid-cavernous fistulas (CCFs) were suspected and confirmed with CT angiography and catheter angiography. He underwent successful coil and Onyx embolisation of the left cavernous sinus and immediately noticed worsening of the double vision when looking left due to a worse left 6 NP. Three weeks later, he underwent similar treatment of the right CCF and immediately noticed worsening of the double vision when looking to the right and was found to have a worse right 6 NP. His double vision resolved 6 months later. CCFs are rare causes of bilateral 6 NPs and although there is a good prognosis, symptoms may worsen after treatment.
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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 | 0.004 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.003 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
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".