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Aug 16 • 5 tweets • 9 min read
📌 Major changes in the Boston Criteria v.2.0 for Cerebral Amyloid Angiopathy diagnosis 👇

(🧵 1/4)

#neurotwitter #FOAMrad #radres #NeuroTwitter #NeuroRad #Neurology #Neurosurgery #RadEd #stroke #dementia #brain #Alzheimers
📌 Summary Panel on "Probable CAA"👇🏿

🩸🧠Most commonly used CAA diagnostic category

#FOAMrad #NeuroTwitter #NeuroRad #Neurology #Neurosurgery #RadEd #stroke #DementiaJoe
🧠🎯Key MRI markers of Cerebral Amyloid Angiopathy

- Easy to look for in clinical MRI scans
- Typical examples and MRI signal 👇

@gboulouis @marco_pasi85 @lsveikata @Cuneatos @svinsociety @MayoClinicNeuro @MayoRadiology

Full set of Boston Criteria v.2.0 from @TheLancetNeuro

Free PDF👇 still available

📢 Stay tuned for an interesting Q&A session with the @WorldStrokeEd during which we discussed all the questions we received!

(cc: @WorldStrokeOrg @interneurona @laura_wsa @gsaposnik @vishnuvy)

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More from @a_charidimou

Andreas Charidimou MD, PhD Profile picture
Jun 16
📌How to design a brain 101🧠🏗️

A 🧵 on how I use @powerpoint to create illustrations

🎨Key tools and my 2 secret weapons:

-@gboulouis adding "advanced" stuff
-@MVarkanitsa reviewing every little detail

#MedTwitter #MedEd #NeuroTwitter #NeuroRad #Neurology #neuropath #FOAMed
This 🧵 is inspired by a great recent post from @teachplaygrub, since we are using similar methods and tools on #PowerPoint!

🛠️ The Basic Toolkit:
-curve function ➰
-edit points function✴️
-Layering 🃏
-Zooming (x300-400%) for details 🔍

🎨 colors, shadows, 3D effects etc., depends on individual's style

1/
Read 15 tweets
Andreas Charidimou MD, PhD Profile picture
Jun 15
🚨Early management of Intracerebral Hemorrhage🩸🧠

📒 My cheat-sheet
(focus on approaches to limit hematoma expansion)

#MedTwitter #neurotwitter #NeuroTwitter #NeuroRad #Neurology #Neurosurgery #stroke #MedStudentTwitter @gboulouis @marco_pasi85 @NMatch2023 #FOAMncc
⚡️For anticoagulation reversal in ICH, see this high yield and simple algorithm from @American_Heart updated ICH 2022 guidelines🩸🧠 @StrokeAHA_ASA
For a quick summary of the @American_Heart updated ICH 2022 guidelines 🩸🧠, the recent 🧵 that @MicieliA_MD put together is amazing

Read 5 tweets
Andreas Charidimou MD, PhD Profile picture
Jun 14
💥Dramatic Intracerebral Hemorrhage🩸🧠 expansion.

Hyperacutely➡️again showing that the window for intervention in ICH is pretty narrow!

⏰=💥🩸🧠

🙏🏿@VancouverStroke for reminding me of these cases!

#neurotwitter #NeuroTwitter #NeuroRad #Neurology #Neurosurgery #stroke
Case report from @JAMANeuro @JAMANetwork

cc: @ComaRecoveryLab @salvasapedraza @neurologiagye @NeuroFOD @EmoryNeurorads @MGHNeurology

jamanetwork.com/journals/jaman…
Here is the case of ongoing bleeding @VancouverStroke mentioned yesterday. @TheLancet @TheLancetNeuro

thelancet.com/journals/lance…
Read 4 tweets
Andreas Charidimou MD, PhD Profile picture
Jun 13
The🟡 Spot Sign might be dead🧟🧟‍♂️ for ICH🧠🩸!

(At least as practice-changing marker for Intracerebral Hemorrhage expansion)

🍄ICH shape/density markers on plain NCCT are more promising👇🏿👇🏿

#neurotwitter #FOAMrad #radres #NeuroTwitter #NeuroRad #Neurology #Neurosurgery #stroke Image
NCCT markers of hematoma expansion picture from: pubmed.ncbi.nlm.nih.gov/31364773/

These markers still need harmonization and improvement of diagnostic accuracy..
pubmed.ncbi.nlm.nih.gov/34842473/ Image
Are you using NCCT markers for hematoma expansion in your practice? @ESOstroke @interneurona @caseyalbin @NikolaSprigg @IntJStroke @SchreuderFloris @BleedingStroke @PrCCordonnier @DrSaccoNeuro @nsanar @Dr_No_Charite @gsaposnik
Read 6 tweets
Andreas Charidimou MD, PhD Profile picture
May 18
re: ICH Prevention in People w ⬆️Risk MRI findings in @American_Heart updated 2022 ICH guidelines🧠🩸

📌 Refers to incidentally found MRI markers of small vessel disease (SVD) - a common question

Prompted by @interneurona unpacking below (short 🪀)
For context:
🚫MRI is not routinely done for risk stratification of first-ever spontaneous ICH risk

🔮MRI is occasionally available in certain people/pts w/o ICH: may show SVD markers concerning for future ICH risk

〽️These markers are: microbleeds, superficial siderosis

1/
The populations that this might be relevant to are:
- healthy elderly
- ischemic stroke
- memory clinic
- any pt who got a brain MRI for a different indication (e.g. migraines)
- non-ICH cerebral amyloid angiopathy (CAA)

#neuroradiology #Alzheimers #stroke

2/
Read 12 tweets
Andreas Charidimou MD, PhD Profile picture
Feb 20
🚨 🧵 Some pearls on cases I have seen last week during night call @bmcneurology @The_BMC 🧠
PRES, RCVS, Trigeminal autonomic cephalalgia, vertigo, IIH, hyperglycemic hyperosmolar syndrome, hyperK, SAH, a tone of CODES STROKE, a tone of seizures
#NeuroTwitter #MedEd #Neurology
1/
 PRES 🗜️
⚡️huge spectrum
⚡️high index of suspicion in ptns with risk factors (often with HTN urgency, immunosuppression, sepsis) + seizures
🕵🏻‍♂️may not be posterior, may not be reversible, may not present as a syndrome!!
emcrit.org/ibcc/pres/ @PulmCrit
2/
⚡️RCVS
-observe (MRI, CTA), remove triggers, be cautious not to miss a dissection @interneurona
-pain control, this is the worst imaginable pain: Mg IV, opioids
-CaCB may help with headache - no proved benefit for vasoconstriction
@AneeshSinghalMD @CajalButterfly
@UpToDate
Read 10 tweets

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