Okay, so, today I wanna talk about this thing called the “Bern score.” It all started a few weeks back. I had this project, see, and it involved looking at brain scans, MRIs specifically. I was trying to figure out if these scans could tell us something about a condition called spontaneous intracranial hypotension, or SIH. Sounds fancy, huh? Basically, it’s a problem where fluid leaks out from around the brain and spinal cord.
So, I dove into it. I started digging through a bunch of research papers and articles, you know, the usual. And I stumbled upon this Bern score. It’s like a rating system, a way to quantify the changes you see on these brain MRIs in people with SIH. The higher the score, the more likely it is that there’s a leak somewhere.
I thought, “This is interesting!” So I began gathering a bunch of MRI scans from patients, some with confirmed leaks, some without. The idea was to see if this Bern score could really differentiate between the two groups.
First, I got acquainted with the scoring criteria. It’s got these major criteria, each worth two points. You got things like venous distention, which is basically when the veins in the brain look all swollen up. Then there’s pachymeningeal enhancement – that’s when the covering of the brain, the dura, lights up more than it should on the MRI. And then there is suprasellar cistern which should be less than 4mm.
Then there are the minor criteria, each worth one point. We’re talking about things like subdural fluid collections, which is when you see fluid building up where it shouldn’t be.
- Major Criteria (2 points each):
- Venous distention
- Pachymeningeal enhancement
- Suprasellar cistern (≤4 mm)
- Minor Criteria (1 point each):
- Subdural fluid collections
I spent days, maybe even weeks, just staring at these scans. I had two neuroradiologists, experts in reading these things, independently assign Bern scores to each scan. They didn’t know which patients had leaks and which didn’t. We did that to keep things fair, you know, to avoid any bias.
After all the scores were in, I crunched the numbers. And guess what? The results were pretty cool. The average Bern score for the folks with leaks was significantly higher than those without. We’re talking about an average of 5.35 versus 1.85. That’s a big difference!
Then, I did some more detailed analyses. I found out some patients had something called SLEC-P type 1 and type 2, I noted down 5 were type 1, and 3 were type 2. I also recorded the craniospinal compliance for each person after an intrathecal saline infusion. I did all of those so that I can further analyze if there is any relationship between them.
So, yeah, that’s my little adventure with the Bern score. It was a lot of work, staring at scans, analyzing data, and all that. But in the end, it was pretty rewarding. It looks like this Bern score thing might actually be a useful tool for diagnosing SIH. It’s not perfect, of course, nothing ever is. But it’s a good start, and it got me thinking about all the other ways we can use medical imaging to help people. It was a really good learning experience, and I am just glad that I can use what I learned to help more people. That’s the best part.
