Teaching NeuroImage: Vessel Wall MRI Features of Meningovascular Syphilis
Bibliographic record
Abstract
A 67-year-old man presented with hemifacial weakness and maculopapular rash, treated as Bell palsy.Initial CT angiogram was normal.6 weeks later, he developed dizziness, diplopia, ataxia, and worsening rash.MRI revealed midbrain, pontine, and thalamic infarcts.An infectious vasculitis was suspected.Vessel wall MRI (VWMR) showed near-occlusion and concentric enhancement of the distal basilar and bilateral P1 PCAs (Figure 1), corroborated with a CT angiogram (Figure 2).His serum syphilis RPR was positive to 256 dilutions, and lumbar puncture revealed a positive CSF VDRL.A diagnosis of meningovascular syphilis (MVS) was made.He was treated with penicillin G 4M units IV every 4 hours for 14 days.Six-week followup angiogram was stable, and his deficits resolved.MVS is a rare cause of recurrent infarcts, with increasing incidence. 1Concentric, multifocal enhancement and VWMR patterns of vessel wall thickening can identify infectious and inflammatory vasculitides such as MVS. 2 VWMR is a useful adjunct to clarify the etiology of intracranial vasculopathies.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".