A case of revascularization for acute bilateral cervical internal carotid artery occlusion
Bibliographic record
Abstract
両側頚部内頚動脈が同時に急性閉塞を来す症例は非常に稀だが，病態は重篤で予後改善には迅速な診断と治療を要する．症例は81歳女性，意識障害で救急搬送され，来院時は心房細動を認め，JCS 300, NIHSS 40点であった．頭部単純CTでは両側ともにAlberta Stroke Program Early CT Score 10点，CT perfusion imagingでは両側大脳半球の広範なtime-to-maximum遅延と，cerebral blood volumeの低下を認めた．Four-dimensional CT-angiographyでは前方循環系の描出を認めず，両側後交通動脈の発達も認めなかったことから急性両側内頚動脈閉塞と診断した．発症1時間程度であったためrt-PA静注療法に加え，機械的血栓回収術を開始し，左はmodified thrombolysis in cerebral infraction （mTICI） grade 3, 右はmTICI grade 2aの開通を得て終了した．しかし神経所見の改善は得られず，両側大脳半球の著明な脳浮腫を来し，術後5日目に死亡した．急性両側内頚動脈閉塞のtherapeutic windowは非常に狭く，再開通までの時間により予後が規定されるため，迅速な診断と治療が望まれる．
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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".