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Andreas Charidimou MD, PhD Profile picture
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Aug 26 • 17 tweets • 10 min read
🧠🩸Intracerebral Hemorrhage (ICH) Location Quiz

⚜️ Is it lobar or deep? That is the question...

👇🏿👇🏿👇🏿 (🧵/6)

#neurotwitter #MedEd #FOAMed #EndNeurophobia #tweetorial #FOAMrad #radres #NeuroTwitter #NeuroRad #Neurology #Neurosurgery #RadEd #stroke
ICH CASE 1⃣
🧠🩸Is ICH CASE 1⃣ lobar or deep?
ICH CASE 2⃣
🧠🩸Is ICH CASE 2⃣ lobar or deep?
🧠🩸ICH CASE 3⃣
🧠🩸Is ICH CASE 3⃣ lobar or deep?
ICH CASE 4⃣
🧠🩸Is ICH CASE 4⃣ lobar or deep?
ICH CASE 5⃣
🧠🩸Is ICH CASE 5⃣ lobar or deep?
ICH CASE 6⃣
🧠🩸Is ICH CASE 6⃣ lobar or deep?
Thank you for the participation/RT @caseyalbin @MicieliA_MD @nsanar @ChaturvediNeuro @ShadiYaghi2 @NguyenThanhMD @hugoapariciomd @draravindganesh @gboulouis @Ellis_van_Etten @rohitmarawar @marco_pasi85 @getcud @lsveikata @VancouverStroke @CamStroke @PrCCordonnier @BleedingStroke
Since many people are asking, answers will be posted over the weekend #neurotwitter #stroke! Thank you for all the enthusiasm!!
(My) Answers to 🩸🧠Intracerebral Hemorrhage Quiz!

Obviously there is no reference standard, lobar vs. deep ICH classification could be at times tricky, but operational rules to help do exist.

Will share some of them & do cases analysis in f/up 🧵, stay tuned!

#neurotwitter

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More from @a_charidimou

Andreas Charidimou MD, PhD Profile picture
Aug 16
📌 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

Read 5 tweets
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

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