Discover and read the best of Twitter Threads about #AcuteNeurologySurvivalGuide
Most recents (5)
1/
A pt w/ ESRD on HD, a fib on coumadin is transferred after a 2 wk hosp for SDH/contusions + ESBL PNA w/ status epilepticus
Scan ⬇️
AEDs: fPHT 100mg Q8H, LEV 1g BID, LAC 100mg BID, VPA 750mg BID + propofol 30, midaz 5.
Admission VPA level 13 (tx range 50-~100)
🤔🤔🤔
A pt w/ ESRD on HD, a fib on coumadin is transferred after a 2 wk hosp for SDH/contusions + ESBL PNA w/ status epilepticus
Scan ⬇️
AEDs: fPHT 100mg Q8H, LEV 1g BID, LAC 100mg BID, VPA 750mg BID + propofol 30, midaz 5.
Admission VPA level 13 (tx range 50-~100)
🤔🤔🤔
2/
Whats going on… That’s a 15mg/kg/day dose… why is the VPA level so low?
Whats going on… That’s a 15mg/kg/day dose… why is the VPA level so low?
3/
VPA is a great AED.
But a @medtweetorial #tweetorial, on how in the critically ill, this drug often becomes problematic and complicated.
#EmoryNCCTweetorials.
VPA is a great AED.
But a @medtweetorial #tweetorial, on how in the critically ill, this drug often becomes problematic and complicated.
#EmoryNCCTweetorials.
1/
It was a delight to work with @gabifpucci of @neudrawlogy to explore the incredibly diverse CNS complications of infective endocarditis!
An #infographic & #tweetorial investigating the radiographic & clinical findings in IE + some management pearls!
#MedEd #Neurotwitter
It was a delight to work with @gabifpucci of @neudrawlogy to explore the incredibly diverse CNS complications of infective endocarditis!
An #infographic & #tweetorial investigating the radiographic & clinical findings in IE + some management pearls!
#MedEd #Neurotwitter
The most common cause of neurologic injury in IE is ischemic stroke.
But! Management is somewhat different.
Notably, due to the high risk of hemorrhagic transformation, tPA is relatively contraindicated or should be used with extreme caution.
You don’t want to end up with ⬇️!
But! Management is somewhat different.
Notably, due to the high risk of hemorrhagic transformation, tPA is relatively contraindicated or should be used with extreme caution.
You don’t want to end up with ⬇️!
3/
As evidence: in this series, 1 in 5 patients experienced post-tPA ICH and only 10% achieved a good outcome.
Thrombolysis for Ischemic Stroke Associated With Infective Endocarditis ahajournals.org/doi/full/10.11…
As evidence: in this series, 1 in 5 patients experienced post-tPA ICH and only 10% achieved a good outcome.
Thrombolysis for Ischemic Stroke Associated With Infective Endocarditis ahajournals.org/doi/full/10.11…
A #tweetorial #medtweetorial
@MedTweetorials
1/
3 AM: Pager Pager Pager
Me [very groggily]: Hey, what’s up?
Awesome overnight APP: Sorry to wake you! But, Mrs. Very-Small-Stroke-NIHSS-2-Had-Been-Clinically-Stable-All-Day just PEA arrested.
Me [not so groggily]:
@MedTweetorials
1/
3 AM: Pager Pager Pager
Me [very groggily]: Hey, what’s up?
Awesome overnight APP: Sorry to wake you! But, Mrs. Very-Small-Stroke-NIHSS-2-Had-Been-Clinically-Stable-All-Day just PEA arrested.
Me [not so groggily]:
2/
Awesome APP: We successfully got ROSC (bc team
@emoryneurocrit
= Flexed bicepsStar-struck) and have him stabilized. Going to scan now!
So, #neurotwitter, where’s the lesion?
Awesome APP: We successfully got ROSC (bc team
@emoryneurocrit
= Flexed bicepsStar-struck) and have him stabilized. Going to scan now!
So, #neurotwitter, where’s the lesion?
3/
Trick question.
All of these areas through neurologic pathology – stroke/seizure/bleed - could all have caused a sudden death (or at the very least sudden LOC).
Trick question.
All of these areas through neurologic pathology – stroke/seizure/bleed - could all have caused a sudden death (or at the very least sudden LOC).
1/
Attending: “But never anticoagulation for an intracranial dissection!”
Me as a resident: “Of course. Totally!”
Also me ⬇️: [googling “where do the internal carotid arteries and vertebral arteries become intracranial?”]
Feel familiar? A #tweetorial @MedTweetorials
Attending: “But never anticoagulation for an intracranial dissection!”
Me as a resident: “Of course. Totally!”
Also me ⬇️: [googling “where do the internal carotid arteries and vertebral arteries become intracranial?”]
Feel familiar? A #tweetorial @MedTweetorials
2/
With the TREAT-CAD trial, lots of talk about dissection treatment. Whether your team anti-platelets or team anticoagulation (🙋🏻 Must. Give. Heparin (@MGHNeurology) 4 ever. I know you feel this, @namorris!) consideration about the location of dissection is possibly important.
With the TREAT-CAD trial, lots of talk about dissection treatment. Whether your team anti-platelets or team anticoagulation (🙋🏻 Must. Give. Heparin (@MGHNeurology) 4 ever. I know you feel this, @namorris!) consideration about the location of dissection is possibly important.
3/
Also, regardless of your team… TREAT-CAD was not able to demonstrate non-inferiority of ASA, just saying.
Aspirin versus anticoagulation in cervical artery dissection (TREAT-CAD): an open-label, randomised, non-inferiorit… pubmed.ncbi.nlm.nih.gov/33765420/
Also, regardless of your team… TREAT-CAD was not able to demonstrate non-inferiority of ASA, just saying.
Aspirin versus anticoagulation in cervical artery dissection (TREAT-CAD): an open-label, randomised, non-inferiorit… pubmed.ncbi.nlm.nih.gov/33765420/
1/ Alright, #Neurotwitter, the votes for today’s #neuroDDxThursday were overwhelmingly in favor of multiple cranial neuropathies!
Thought about one slide, but this needs a #tweetorial! So that you aren't 😬😬😬 when confronted with this:
#MedEd #FOAMed @MedTweetorials
Thought about one slide, but this needs a #tweetorial! So that you aren't 😬😬😬 when confronted with this:
#MedEd #FOAMed @MedTweetorials
2/
Reminder: The 12 cranial nerve nuclei are located in the brainstem, and if you have trouble remembering where they are, welcome to the club. Here’s a reminder! Will post the medulla section Monday, stay tuned.
Reminder: The 12 cranial nerve nuclei are located in the brainstem, and if you have trouble remembering where they are, welcome to the club. Here’s a reminder! Will post the medulla section Monday, stay tuned.
3/
We’ll move from central to peripheral etiologies.
The brainstem is like Times Square in NYC- so much going on in a very small space.
A small insult can easily cause damage to multiple cranial nerves. amiright, #stroketwitter?
We’ll move from central to peripheral etiologies.
The brainstem is like Times Square in NYC- so much going on in a very small space.
A small insult can easily cause damage to multiple cranial nerves. amiright, #stroketwitter?
