1 yr Outcomes in Conservatively vs Surgically Treated Cerebellar Infarcts: 35 mL or greater, a higher rate of favorable outcomes w/ surgically treated (38 [61%] vs 3 [25%]; OR, 4.8; 95% CI, 1.2-19.3; P = .03) jamanetwork.com/journals/jaman…

ATAMIS = NIHSS 4-10: #DAPT x 14 days reduced early neurological deterioration no change in 90 day mRS. Pushing beyond NIH 0-3 (CHANCE & POINT)! #neurocritical #neurotwitter #stroke jamanetwork.com/journals/jaman…

Happy docs day! Appreciate the team that makes it all happen 🙏🤓 Intermountain Health #neurotwitter #neurocriticalcare #DoctorsDay2024

Patience pays off - at long last, our final manuscript on bromocriptine for central fever has been published! We describe 30 pts where bromocriptine was used for central fever. It was modestly effective overall, although some patients (esp SAH patients) saw a dramatic response

The number needed to treat to prevent 1 seizure was 167 patients.

The Trial of Early Minimally Invasive Removal of Intracerebral Hemorrhage (ENRICH) by Pradilla G et al in N Engl J Med summarized in 5 points: 1.🧠 This Bayesian adaptive randomized clinical trial investigated early minimally invasive neurosurgery for removing intracerebral

Poisson Modeling Predicts Acute Telestroke Patient Call Volume. Our piece on mathematical prediction of telestroke calls, relevant to any health system!! #telestroke #neurocriticalcare #neurotwitter Telemedicine Journal @americantelemed @intermountain pubmed.ncbi.nlm.nih.gov/38603583/

2024 AHA/ASA Performance and Quality Measures for Spontaneous Intracerebral Hemorrhage. 15 good ICH benchmarks! ahajournals.org/doi/abs/10.116… #neurocriticalcare #stroke #ich #neurotwitter #teleneurocriticalcare Intermountain Health #codeich Josh Goldstein Claude Hemphill

#ESOC2024 🩸SWITCH TRIAL🩸 👉 DC in deep ICH WITHOUT evacuation vs BMT alone 👉 mRS 5-6 at 6 m 44% DC vs 58% BMT 👉Severe adverse effects: 41% in DC vs 44% in BMT 🟡 Week evidence in favor DC in deep location

No benefit of TNk compared to standard of care for mild (non disabling) stroke presentations with intracranial occlusion/CTP deficit. Definitive answer to this patient population. The Lancet Neurology #stroke #neurology thelancet.com/journals/lance…

Here’s an interesting OP-ED by a group of esteemed neurointensivists exploring the benefits for SABI pts when treated in a dedicated neuro-ICU link.springer.com/article/10.100…

Here it is! In this meta-analysis, anticoagulation was superior to antiplatelets for stroke prevention in patients with #cervical #artery #dissection but carried increased risk of major bleeding. This argues for an individualized treatment approach. 🛑CAD ahajournals.org/doi/10.1161/ST…

Investing in the Right Thing: How Simplified, Value-Based Care [Intermountain Health ] Moves Health Upstream | NEJM Catalyst catalyst.nejm.org/doi/full/10.10…

Still using the #HuntHess scale from 1968 for SAH prognosis? Many in the US and internationally continue to rely on this classic scale, following guidelines from DNV and JCAHO News + Consult. But medicine evolves, and so should our tools. It's prime time for an upgrade hence myself,

In post-cardiac arrest #coma, the ERC-ESICM 2021 algorithm is 100% specific for poor outcome prediction, and in patients with indeterminate outcome, favourable signs predict recovery with 99% specificity! Online on Resuscitation pubmed.ncbi.nlm.nih.gov/39151721/

Intracerebral Hemorrhage & Surgical Management Trials - thanks Nicholas Morris ! neurology.org/doi/10.1212/WN…

Balloon angioplasty + aggressive medical management may be effective for symptomatic intracranial atherosclerotic stenosis, although risk of stroke or death within 30 days of balloon angioplasty should be considered in clinical practice. ja.ma/3TcBLzV

2024 ESC Guidelines for Afib: CHA2DS2–VASc is now CHA2DS2–VA; Why? Inclusion of gender omits individuals who identify as non-binary, transgender, or tx w/ sex hormone therapy. Also IIa rec for AC for score = 1. Daniel M Philbin, MD #neurocriticalcare #stroke academic.oup.com/eurheartj/arti…