Today's Paper of the Day is on brain monitoring after cardiac arrest

criticalcarereviews.com/latest-evidenc…

Join us to read 1 paper per day and stay up-to-date as we cover the spectrum of critical care across 2024

When do you suspect DCI in qEEG? These are the highlights. Created between EEG-texts with our cool and very talented Erafat Rehim

#NeuroTwitter #MedEd #EEG Emory & Grady Neurocritical Care Fellowship Casey Albin, MD Rebecca E. Matthews, MD Zeke Gleichgerrcht, MD, PhD EEGTalk

You're under no obligation to remain the same person you were a year ago, a month ago, or even a day ago. You are here to create yourself, continuously.

Emergency physicians are increasingly turning to CTA and are less often using lumbar puncture for headache evaluations. In this study is sixfold increase in CTA what is associated with more aneurysms being diagnosed, and no missed cases of SAH.

jamanetwork.com/journals/jaman…

Tranexamic acid vs placebo within 2 h of #ICH onset (STOP-MSU): an international, double-blind, trial

Primary outcome measure was ICH growth.

Turns out that TXA has absolutely NO effect on ICH expansion, which was ~30% in both groups.

Zilch. Nada.

thelancet.com/journals/laneu…

Not a common challenge to confront, but it happens….

Outcomes of Decompressive Craniectomy (DC) for Patients With Severe Cerebral Venous Thrombosis: DECOMPRESS2

In this uncontrolled cohort study 2/3 survived and over 1/3 have a good outcome (mRS 0-2).

The majority of…

20 years ago jan claassen and I co-authored a systematic review of the relative benefits pentobarbital, midazolam and propofol for refractory status (RSE).

They all worked about the same.

This Neurology Today article highlights the clinical impact of a recent update on…

My latest, from the #SHINE trial, in which DM2 patients with #AIS were randomized to intensive insulin therapy using a computer algorithm to target strict normoglycemia (80-120 mg/dl) as opposed to conventional therapy with Q6 IV push insulin to treat glucose levels >180.

In…

Really nice multicenter study looking at severe ICH growth (>66% or 12.5 ml)

A concept that has not yet been examined. If this happens — it’s bad.

Most interesting finding is intraclot hypodensities and CTA spot sign.

The other findings — as expected — are shorter…

My latest with Fawaz Al-Mufti, MD, FSVIN from New York Medical College Westchester Medical Center

HIT can be devastating, causing excessive hyperthrombosis. It is caused by the formation of antibodies that activate platelets after heparin administration.

Although rare (about 1 in 400 SAH cases) HIT can be…

Nice review of Noninvasive neuromonitoring in acute brain injured patients

In my book cEEG and pupilometry lead the way

⁦Curing Coma⁩ #curingcoma link.springer.com/article/10.100…

I work with an amazing neurology department led by Tracey Milligan, MD, MS, FAAN, FANA, FAES who is the bomb! All of my partners at New York Medical College are fantastic. Love you all.

It takes a team.

Be a team builder.

#AANAM
Westchester Medical Center

Choosy about who to send to the lab?

In this cool retrospective study #LVO patients with zero CTP mismatch (so called malignant pattern) with ASPECTS 3-7 still did better with thrombectomy! If age <70.

“The only good vessel is an open vessel”

ahajournals.org/doi/abs/10.116…

I don’t know who needs to hear this, but ancillary testing is no substitute for the clinical exam/apnea test if the examiner is able to perform the clinical exam/apnea test.

Big thanks to our artist Asim Ahmed New York Medical College soon to be #Neurology resident. NYU Langone Hospital—Long Island #AANAM #EducationRoom American Academy of Neurology

Join us bright & early tomorrow for an invigorating session challenging the status quo in acute stroke care!
Thu, Apr 18 7:45-8:15 AM
Colorado Convention Center - Mile High 1EF
#AANAM American Academy of Neurology
Columbia Neurology Residency Westchester Medical Center NYU Neurology Residency NYMC Department of Neurology New York Medical College

Secondary analysis of the Earlydrain trial in #SAH . Placement of a lumbar drain in addition to an EVD improves outcome. In this analysis increased lumbar drainage volumes (ml and % of total CSF) correlated with decreased risk of infarction.

link.springer.com/article/10.100…

Trial of Early Minimally Invasive Removal of Intracerebral Hemorrhage

ENRICH NEJM

Positive effect showing better outcomes in lobar #ICH 30-80 ml with MIS performed <24 hrs

No effect in deep bleeds — likely because that size range is devastating for a basal ganglia bleed…