Primary Goal: Improve delivery of neurocritical care through research/education
Secondary goal: Share wife's floral design talents at https://t.co/niITArVPQP
Jun 15, 2023 • 4 tweets • 2 min read
It is fitting that this issues is being published soon after the passing of Dr. Marty Samuels. Among his many gifts, he was a clinical virtuoso at the intersection of medical and neurological illness. Neurocardioloy, neurohematology, neuronephrology, neurorheumatology...
In defining these fields, he brought the best out of all of us... stressing holistic patient care, collaboration, and curiosity. He imbued us with a passion for caring for conditions that fell between subspecialty cracks. I am so grateful to have learned from him...
Sep 27, 2022 • 13 tweets • 11 min read
1/11 A few years ago, I took care of two young women (some details changed) with similar scans… a brief thread about how MRI can shape a Ddx… but first a poll: Which lesions can restrict diffusion?
2/ Yes… all of these lesions can restrict diffusion. For more info on restricted diffusion see tweets 9-18 in this wonderful tweetorial from @teachplaygrub:
1/ Do you take care of pts with aneurysmal SAH (aSAH)? How many of them experience vasospasm (VSP) / delayed cerebral ischemia (DCI)? A thread on pathophysiology and novel strategies
2/ Radiographic VSP complicates up to 70% of cases of aSAH and DCI occurs in 20-30% of cases of aSAH…. But… 14% develop infarctions without vasospasm… and nimodipine improves outcomes but not VSP ahajournals.org/doi/10.1161/ST…
May 18, 2021 • 5 tweets • 3 min read
@UMDNeurosurgery's Dr. Aldrich post hoc analysis shows thick (≥ 4mm) and diffuse (≥ 3 basal cisterns) SAH independently predicts vasospasm-related morbidity and poor 12-wk outcomes. thejns.org/view/journals/…@claassen_jan used Hijdra grade 3 (completely fills a cistern) to define "thick blood" in Fisher scale revisited paper + showed additive effect of b/l IVH. ahajournals.org/doi/10.1161/hs…
Mar 12, 2021 • 13 tweets • 8 min read
1/ A trainee approached me re: a "hypothetical" case. A patient p/w acute weakness 90 min after onset of R arm/leg without other neuro deficits. The neurology consultant advised IV tPA after CT/CTA head and neck showed no hemorrhage (and also no LVO). The ED attending balked.
2/ Trainee's ?: Can you have a stroke with only motor involvement? Can you have a stroke that causes weakness of the arm and leg, but not the face?... a short tweetorial
Feb 11, 2021 • 12 tweets • 5 min read
Nice study on Thrombocytopenia and Clinical Outcomes in Intracerebral Hemorrhage. Helps further delineate risks for poor outcome after ICH among patients on antiplatelet agents. ahajournals.org/doi/full/10.11…
Over 1/2 of U.S. adults over 45 take antiplatelet agents (APA). ajpmonline.org/article/S0749-…. Studies show disparate results when investigating effect of APA on outcome. doi:10.1161/01.STR.0000231842.32153.74
doi:10.1161/01.STR.0000196991.03618.31
Feb 5, 2021 • 17 tweets • 8 min read
We recently published our first paper sharing validity evidence for the development of neurological emergency simulations for assessment. Are you familiar with forms of validity evidence? If you are an educator, you should be! A thread… rdcu.be/ceMm3
Steven Downing wrote a fantastic review on validity as it pertains to assessment in medical education. Let’s review the highlights! pubmed.ncbi.nlm.nih.gov/14506816/
Jan 29, 2021 • 15 tweets • 11 min read
IV glibenclamide shows promise for reducing cerebral edema and appears to be safe. PO glyburide leads to more hypoglycemia, especially if abnl renal fxn. Smaller, more frequent dosing may help. Kudos to @MikeA_42 for pushing this through to publication. sciencedirect.com/science/articl…@jessestokum performed work in Dr. Marc Simard's lab demonstrating how SUR1-TRPM4 and AQP4 form a complex that amplifies ion/water osmotic coupling and drives astrocyte swelling after brain injury. @UMDNeurosurgery . onlinelibrary.wiley.com/doi/full/10.10…
