Cerebellar Atrophy in Craniofacial Morphea: A Report of 2 Cases with 1-year Neuroimaging Followup
Bibliographic record
Abstract
To the Editor: Brain magnetic resonance imaging (MRI) findings in craniofacial morphea including en coup de sabre (ECDS) localized scleroderma and Parry-Romberg syndrome (PRS; progressive facial hemiatrophy) are not unusual1, but the relevance of rare abnormalities is unknown. We report 2 cases in which distant cerebellar lesions on brain MRI occurred with varying clinical neurologic manifestations. Ethics approval was not required by the University of Calgary Conjoint Health Research Ethics Board because clinical case series do not fall within the definition of research in the second edition of the Tri-Council Policy Statement: Ethical Conduct for Research Involving Humans (TCPS 2). Consent to report the cases and clinical images were obtained from the patients and their families. Case 1 involves a 10-year-old male who presented with a 5-year history of linear, atrophic, indurated, sclerotic, hyperpigmented, and slightly erythematous plaques involving the right frontotemporal scalp, right forehead, and right temple (Figure 1A). Prior skin biopsy was consistent with morphea (ECDS scleroderma variant). Topical corticosteroids did not provide benefit. Review of systems and neurologic assessment were unremarkable. Repeat skin biopsy revealed active inflammation and laboratory studies showed positive antinuclear antibody (ANA; 1:40 titer). Baseline brain MRI demonstrated right-sided cerebellar hemiatrophy … Address correspondence to Dr. N.J. Luca, ACH C4-348, Alberta Children’s Hospital, 28 Oki Drive, Calgary, Alberta T3B 6A8, Canada. E-mail: nadia.luca{at}ahs.ca
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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 | 0.005 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.004 | 0.002 |
| Science and technology studies | 0.002 | 0.002 |
| Scholarly communication | 0.002 | 0.003 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.006 | 0.003 |
| 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".