Chief of #neurocritcare @ChristianaCare, Assoc SoMe Editor @NeuroCritCareJ, Past Chair Ethics Comm @neurocritical. Passionate about #FOAMed #healthequity #DEI
Oct 30 • 25 tweets • 6 min read
1/ Hi 👋 #medtwitter #neurotwitter #neurocritcare #FOAMed #meded I am here to present you a very scary case, one that you should find terrifying - just in time for #Halloween 👻🧹 Note: case adjusted for teaching purposes
2/ Young person w/ disseminated #coccidiomycosis on lifelong suppressive #fluconazole, #epilepsy on #levetiracetam p/w #seizure. Sz resolved spontaneously, was preceded by N/V. Pt had been unable to take fluconazole or levetiracetam for several weeks but had just restarted them.
Sep 4 • 24 tweets • 6 min read
1/ Hi 👋 #medtwitter #neurotwitter #neurocritcare #FOAMed #meded have another interesting case I wanted to share with you and see if perhaps you learn something new!
2/ We have a young person who presents after being found down. The patient has a history of 🍺 dependence, pancreatitis, portal vein thrombosis. They undergo trauma evaluation and are noted to have some ophthalmoplegia. What do you do?
Jul 1 • 18 tweets • 4 min read
1/ Hi 👋 #medtwitter #neurotwitter #FOAMed #MedEd please join me for another fascinating case!
2/ Middle aged person who was mountain 🚴♀️🚴♂️ when they developed left-sided tingling, vertigo, 🤢🤮 and unilateral hearing loss. Where do you localize the problem?
Apr 8 • 20 tweets • 5 min read
1/ Hi 👋 #medtwitter #neurotwitter #FOAMed #MedEd have a challenging case to share with you! Come join me and hopefully learn something new along the way!
2/ Elderly person, habitual 🍺, presents with left sided deviation 👀 and left sided weakness 😕. They undergo stroke alert. NIHSS 18. CT shown below.
Jul 19, 2023 • 16 tweets • 5 min read
1/13 Hi #Medtwitter #neurotwitter #stroke #neurocritical care, posting a companion case to this recent thread:
Hope you’ll join me through this complex case and maybe get something out of it too! Special 🙏 to @sudhakar_satti for reviewing this case!!
2/ We have a middle aged person with 🚬 use, prior neck CA s/p ☢, found unable to 👄 or stand. Goes to outside 🏥 and is in the window for TNK. CT without hemorrhage and gets TNK.
May 26, 2023 • 23 tweets • 6 min read
1/21 #medtwitter #neurotwitter #neurosurgery just saw a great case by @daniel_gewolb and thought that some more discussion of #cerebralhyperperfusion syndrome (or #CHS) was indicated, in addition to post-op management of patients undergoing #CEA or #CAS.
2/🙏@daniel_gewolb for highlighting this disease and inspiring this tweetorial!
1/ You all ready to learn??? ⏲️ for another teaching case, #neurotwitter#medtwitter#neurorads!!!
2/ Young adult who has been having dysuria for several days, who also has developed LE weakness leading to difficulty with ambulation. Did have an #URI last week but feels completely improved from that.
Oct 26, 2022 • 7 tweets • 5 min read
Great article on neurocritical care of the pregnant patient by Dr. Malaiyandi: ncbi.nlm.nih.gov/pmc/articles/P…
Some pearls:
👉 🔑 tenet is prioritize outcome of mother while minimizing harm to fetus #reproductiverightsarehumanrights
👉PA<AP radiation
👉Use preservative free heparin
👉 NCCT head <0.001mGy exposure👉 Avoid use of lead over abdomen for CT - may actually increase radiation exposure
👉POCUS can raise temp from absorption of sound waves. B-mode best, Doppler worst. Minimize time
👉CT contrast = cat B, use when urgently needed vs MRA when not
Oct 24, 2022 • 24 tweets • 10 min read
1) I am so humbled that over 2K of you now follow me! 🥰. Still beaming from meeting so many peeps at #NCS2022. To celebrate, lets learn from another < than straightforward case #medtwitter#neurotwitter#neurorads#neurocritical2) Middle aged person with HTN, 🚬 and THC daily use, presents w/ 3⃣days of severe HA described as “worst headache of life” ⛈️. We’ve been over this differential before but here it goes again 👇. They undergo CT head which demonstrates SAH and a right frontal IPH:
Sep 25, 2022 • 20 tweets • 13 min read
Get ready for a wild ride! We will be going down a 🐰🕳 and 🔎 multiple issues along the way. Buckle up! As always, all cases deidentified and never published while admitted. #tweetorial#neurotwitter#medtwitter#FOAMed#MedEd#Neurology 1/
Middle aged person with opioid abuse, bipolar, hip abscess, who p/w dysarthria, 🤢🤮. Patient is admitted and has sudden change in MS, undergoes stroke alert. CT with mild ventriculomegaly but no other acute process 2/
Sep 9, 2022 • 25 tweets • 12 min read
There is so much confusion on what #braindeath is and what it is not (see
or dailymemphian.com/subscriber/sec…) that I wanted to provide some education on this critically important matter. A 🧵 on its history and more #neurotwitter#medtwitter
1/
Before mechanical ventilation, death was defined as the cessation of circulation and breathing, and even though it seemed straight forward, a true phobia in the 18th and 19th C was that of being buried alive. Hence #safetycoffins from where the term #savedbythebell is derived: 2/
Jun 29, 2022 • 21 tweets • 9 min read
1/ Time for another illustrative learning case in the form of a 🧵#tweetorial#medtwitter#neurotwitter#neurocriticalcare#neurology. Case deidentified as always
2/ Young human with no medical history but IVDA (heroin, cocaine, PCP) with multiple prior overdoses and recent discharge from drug rehab 2 days prior who presents to #ED after acting funny
