CONTACTS
SUBJECTS
Default Null Subject Account for Blank Record
0403 -
0403 - ..
0404 - Summary/Objective
0405 -
040501 - Follow up ref SDS 15 0000. ref SDS 12 0000.
040502 -
040503 -
040504 -
040505 -
040506 -
040508 - ..
0406 -
0407 -
0408 - Progress
0409 -
040901 - Implement cerebral MRI scheduled yesterday, shown in the record on
040902 - 160816 1611. ref SDS 18 WF5I
040904 - ..
040905 - Cerebral MRI today will test for brain and stroke symptoms that may
040906 - occur after EGD dilation procedure performed yesterday on 160816,
040907 - ref SDS 17 0001, similar to findings 2 months ago from MRI on 160618
040908 - 1348, ref SDS 3 WK7K, which were found following EGD dilation
040909 - procedure the day before on 160617 1637. ref SDS 2 5F6F
040911 - ..
040912 - Went to Radiology on 2nd floor Building 200. Michelle set IV for
040913 - contrast required to perform brain MRI.
040915 - ..
040916 - She was efficient and personable.
040918 - ..
040919 - IV required 2 sticks today, because the number of needle sticks the
040920 - past few weeks, has reduced the number of good targets for sticks.
040922 - ..
040923 - Case study on sticks required to set catheter is reported on 110429
040924 - 1230. ref SDS 1 UO3G
040926 - ..
040927 - Discussed achalasia and EGD procedure on 160617, and afterward stroke
040928 - symptoms, reported on 160617 1637. ref SDS 2 5F6F Care for symptoms
040929 - subsequently required cerebral brain MRI tests for evaluating cause of
040930 - stroke symptoms. Today, is the 3rd MRI for the investigation.
040932 - ..
040933 - Michelle wrote down the name "achalasia", Heller Myotomy surgery, and
040934 - EGD dilation for independent research.
040936 - ..
040937 - Turned out Bella was on staff today. Youseff came into the MRI
040938 - preparation room, but he was kind enough to let Bella do the MRI
040939 - today, because he remembered me commending her work performed OA 0300
040940 - on 160618, ref SDS 3 PX8M, explained in the record on 160617.
040941 - ref SDS 2 027K
040943 - ..
040944 - This took about 40 minutes, closer to the time required for the 1st
040945 - MRI on the brain performed on 160617 1637. ref SDS 2 027K This was
040946 - longer than the MRI done on 160805 0845. ref SDS 15 IN9I
040948 - ..
040949 - Bella was fun to work with, as she was the last time on 160617 1637.
040950 - ref SDS 2 BA6K
040952 - ..
040953 - She removed the IV.
040955 - ..
040956 - Bella made a joke, saying she would make a CD for me to take to
040957 - Stanford Neuroscience, I would tell her that she is pretty, loud
040958 - enough for Youseff to hear.
040960 - ..
040961 - Said something like...
040962 -
040963 - "Oh Bella, you are very pretty."
040965 - ..
040966 - She laughed, and said to wait in the patient area. She will bring the
040967 - CD in about 10 minutes.
040968 -
040969 -
040970 -
040972 - ..
0410 -
0411 -
0412 - 0924
0413 -
041301 - Received CD from Bella for cerebral MRI just completed, per above.
041302 - ref SDS 0 MX82
041304 - ..
041305 - This follows up original MRI on 160618 1348. ref SDS 3 EY9G
041307 - ..
041308 - Prior MRI on brain was performed on 160805 0845. ref SDS 15 YM8N
041310 - ..
041311 - Follows up EGD dilation performed yesterday on 160816 0800.
041312 - ref SDS 17 0001
041314 - ..
041315 - Gearview.exe MRA scan files from are stored in...
041316 -
041317 - Note this will not open in Windows 10, needs Windows 7...
041318 -
041319 - F:\05\00003\SM\CC\GMPF\GFJ\20160817-080000\GEARView.exe
041321 - ..
041322 - Verified the files open in Windows 7, not in Windows 10.
041324 - ..
041325 - Neuroradologist's report was not available 4 hours after completing
041326 - the scan.
041328 - ..
041329 - Will get it from the VA when on campus for meeting on 160810.
041330 -
041331 - [On 160808 0430 drove to VA Medical Center in San
041332 - Francisco, and received neuroradiologist report for MRI
041333 - scan on 160805. ref SDS 16 SJ7N
041334 -
041336 - ..
041337 - Stored neuroradiologist report for MRI on 160805 at...
041338 -
041339 - F:\05\00003\SM\CC\AGMJ\20160805-080000\mhv_WELCH_20160809_1259.txt
041341 - ..
041342 - It is the last report in this file...
041343 -
041344 -
041345 - 1. Procedure/Test Name: MRI BRAIN W&W/O GAD
041346 - Date/Time Exam Performed: 05 Aug 2016 @ 0807
041347 - Ordering Location: San Francisco CA VAMC
041348 - Requesting Provider: MASSA,STEPHEN
041349 - Reasons for Study: brain blood vessel abnormality
041351 - ..
041352 - 2. Clinical History:
041353 -
041354 - f/u of abn enhancement of brain surface blood vessels. Please
041355 - perform 8/5/16 at the time of the ortho MR. Discussed with Dr
041356 - Sugrue.
041357 -
041359 - ..
041360 - 3. Does the patient have one of the following devices?: No
041361 -
041362 - 1. cardiac pacemaker
041363 - 2. cardiac defibrillator
041364 - 3. implanted device or pump
041365 - 4. neurostimulator
041366 -
041368 - ..
041369 - 4. Has this patient had surgery for a brain aneurysm?: No
041371 - ..
041372 - 5. Will this patient need sedation?: No
041373 -
041374 - Sedation orders are the responsibility of the ordering provider
041375 - and should be placed at the time of imaging request.
041376 -
041378 - ..
041379 - 6. Is there anything within this patient that you are unsure about
041380 - in regards to MR safety?: (foreign body, metal object, etc):
041381 - No
041383 - ..
041384 - If yes, please put in a short description below:
041386 - ..
041387 - 7. Performing Location: San Francisco CA VAMC 4150 CLEMENT STREET, SAN FRANCISCO 94121
041388 - Radiologist: WILSON,DAVID M
041389 - --------------------------------------------------------------------------
041390 - RADIOLOGY REPORT
041392 - ..
041393 - 8. Report:
041395 - ..
041396 - MR and MRA Brain with contrast 8/5/2016
041398 - ..
041399 - 9. History: Followup up blood vessel abnormality seen on prior MRI
041401 - ..
041402 - 10. Comparisons: MRI brain 6/18/2016
041404 - ..
041405 - 11. Technique:
041407 - ..
041408 - MRI of the brain and MRA of the neck and brain performed
041409 - without and with contrast at 3 Tesla.
041411 - ..
041412 - 12. Findings:
041413 -
041414 - 1. Interval resolution of the previously seen right
041415 - holohemispheric subarachnoid enhancement which was most
041416 - predominant in the right frontal and occipital lobes.
041417 -
041418 - 2. The cortical blood vessels are no longer abnormal in these
041419 - regions suggesting that their prominence on prior
041420 - examination was due to hyperemia from underlying
041421 - inflammation. No vascular anomaly identified.
041423 - ..
041424 - 3. There is no acute intracranial hemorrhage, acute infarct,
041425 - mass, or mass effect.
041427 - ..
041428 - 4. Normalization of the diffusion signal abnormality seen
041429 - within the right superior cerebellum.
041431 - ..
041432 - 5. The ventricles and sulci are normal for the patient's age.
041434 - ..
041435 - 6. Right maxillary sinus mucous retention cyst.
041437 - ..
041438 - 7. The orbits are unremarkable.
041440 - ..
041441 - 8. No focal bony abnormality is identified.
041442 -
041444 - ..
041445 - 13. MRA:
041446 -
041447 - No hemodynamically significant stenosis or occlusion of the
041448 - major vessels of the neck or brain. Symmetric vascular flow
041449 - within the brain bilaterally.
041450 -
041452 - ..
041453 - 14. Impression:
041454 -
041455 - 1. Interval resolution of the previously seen holohemispheric
041456 - subarachnoid enhancement most conspicuous in the right
041457 - frontal and occipital lobes when compared to 6/18/2016.
041458 - Given the interval resolution of these findings it was
041459 - favored to be infectious or inflammatory.
041461 - ..
041462 - 2. No hemodynamically significant stenosis of the vessels of
041463 - the neck or brain. No vascular malformation identified.
041464 -
041466 - ..
041467 - The images were personally reviewed by David Wilson MD who
041468 - agrees with the above interpretation.
041470 - ..
041471 - Primary Diagnostic Code:
041472 -
041473 -
041474 -
041475 -
041476 -
041478 - ..
0415 -
0416 -
0417 - 1644
0418 -
041801 - Called for...
041802 -
041803 - Doctor Nirali Vora
041804 - Stanford Health Care
041805 - Neuroscience
041806 - 213 Quarry Road
041807 - Palo Alto, CA 94304
041808 -
041809 - 650 725 5792 Option #1
041811 - ..
041812 - Talked to Fernando.
041814 - ..
041815 - He will notify Doctor Vora and Sun Kim, that MRI was performed this
041816 - morning, as scheduled. Customer has the CD. Needs to know where to
041817 - upload for Doctor Vora and Doctor Kim to review.
041819 - ..
041820 - Alternatively, will ship via UPS to Stanford.
041822 - ..
041823 - The doctor can view the file anytime via Google Remote Access.
041824 -
041825 -
041827 - ..
0419 -
0420 -
0421 - 1000 on 160806
0422 -
042201 - Next morning called for Jesse again at...
042202 -
042203 - 650 725 5792
042205 - ..
042206 - Used contact information in the record on 160801 0813. ref SDS 10 WF5I
042208 - ..
042209 - Talked to Michelle.
042211 - ..
042212 - She said to setup account on Stanford cloud system, call...
042213 -
042214 - 866 367 0758
042215 -
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0423 -