Anteromedial striatum and globus pallidus infarcts: Uncommon complications of cerebral herniation in the setting of acute subdural hemorrhage
Bibliographic record
Abstract
Herniation of the temporal lobe through the tentorial notch often leads to compression of the ipsilateral posterior cerebral artery and stretching of the ipsilateral oculomotor nerve. Arterial compression classically results in infarcts of the inferior temporal and occipital lobes. Herniation of the cingulate gyrus beneath the falx cerebri often leads to compression of branches of the ipsilateral anterior cerebral artery, including the pericallosal artery, which classically results in infarcts of the cingulate gyrus and medial corpus callosum. A less common consequence of transtentorial herniation is compression of perforating branches from the internal carotid and anterior cerebral arteries supplying the inferomedial anterior basal ganglia. Compression of the anterior choroidal artery, a branch of the internal carotid, and the recurrent artery of Heubner, a branch of the anterior cerebral artery, can cause infarcts of the ipsilateral anteromedial striatum and globus pallidus, but these are rarely seen at autopsy. In this report, we present the case of a 51-year-old lady with a large left acute subdural hemorrhage (SDH). At autopsy, we observed left subfalcine and transtentorial herniations with a typical pattern of secondary infarcts due to compression of the posterior and anterior cerebral arteries. In addition, we observed cavitation of the left inferomedial anterior caudate and putamen and globus pallidus internus due to compression of perforating arteries, including the left anterior choroidal artery and the left recurrent artery of Heubner. This case illustrates perforating artery infarcts, an uncommon pattern of secondary ischemic injury, in the setting of SDH.
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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 | 0.002 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| 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 | 0.001 | 0.001 |
| 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".