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Record W4403869500 · doi:10.1148/radiol.240620

Case 334

2024· article· en· W4403869500 on OpenAlexaffabout
Maria Lucia Brun‐Vergara, Nader Zakhari, Carlos Torres

Bibliographic record

VenueRadiology · 2024
Typearticle
Languageen
FieldMedicine
TopicInfectious Diseases and Tuberculosis
Canadian institutionsOttawa Hospital
Fundersnot available
KeywordsMedicineChillsLethargyDiplopiaNeurological examinationRetchingPhysical examinationSurgeryNeck painLumbar puncturePast medical historyDroolingEmergency departmentMedical historyNauseaCerebrospinal fluidInternal medicine

Abstract

fetched live from OpenAlex

History A 30-year-old female patient who was 25 weeks pregnant presented to the emergency department with a 1-month history of mild headache and 2 weeks of progressive somnolence and photophobia accompanied by binocular horizontal diplopia and right gaze deviation. The patient also described new neck pain with passive head movements, without neck stiffness. Overall, the pregnancy was uncomplicated, with no high-risk features. Fever, chills, cough, shortness of breath, and abdominal or chest pain were denied. The patient had no history of rash, intravenous drug use, immunosuppressive medication use, or documented congenital abnormalities. She had not traveled recently, although she lived in Vancouver, British Columbia, Canada, 2 years prior to presentation. There was no recent or recurrent bacterial or viral illness. At clinical examination, the patient exhibited a decreased level of alertness and appeared tired. Vital signs were unremarkable, with a normal temperature (37.1 °C). Cranial nerve assessment revealed mild right abducens nerve palsy; neurologic examination was otherwise normal. Fundoscopic examination showed moderate grade 3 papilledema, left greater than right, with obscuration of some of the vessels leaving the disk. A CT scan of the head at admission was interpreted as normal ( Fig 1 ). MRI of the brain performed 5 days later, due to persistent symptoms, revealed infratentorial and supratentorial imaging abnormalities ( Figs 2 – 5 ). Lumbar puncture revealed high cerebral spinal fluid (CSF) opening pressure (32 cm H 2 O; upper limit of normal, 25 cm H 2 O). The CSF was clear, and analysis revealed an elevated total nucleated cell count (136 ×10 6 /L; reference range, 0–5 ×10 6 /L), with predominant lymphocytic moderate pleocytosis (100 ×10 6 /L; reference range, 0–5 ×10 6 /L) (59% lymphocytes) and normal glucose (3.3 mmol/L; reference range, 2.2–3.9 mmol/L) and normal total protein (0.27 g/L; reference range, 0.16–0.49 g/L) levels. Blood culture results for mycobacteria and anaerobic and aerobic microorganisms showed no growth. Findings from extensive additional diagnostic workup, including serologic testing for herpes simplex virus, varicella-zoster virus, enterovirus, Brucella, Coccidioides, Histoplasma, and mycobacteria, were negative. The HIV test result was negative, and the CD4 lymphocyte count and complement and immunoglobulin levels were within normal range. Autoimmune screening results were also negative.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesInsufficient payload (model declined to judge)
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Case report · Consensus signal: Case report
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.277
Threshold uncertainty score1.000

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0010.000

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.

Opus teacher head0.013
GPT teacher head0.288
Teacher spread0.275 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

Study designCase report
Domainnot available
GenreEmpirical

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".

Quick stats

Citations0
Published2024
Admission routes2
Has abstractyes

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