Archive for category: Neurology

Does Targeted Temperature Management Actually Work?

28 Nov
November 28, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketThe use of therapeutic hypothermia (TH) has become part of the routine care of patients after return of spontaneous circulation (ROSC) from cardiac arrest (Use of the phrase Targeted Temperature Management has become more accepted). It became much more accepted after two separate trials were published in the New […]

American College of Emergency Physicians (ACEP) Conference 2016

20 Oct
October 20, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketThis years ACEP 2016 conference took place in Las Vegas, NV from Oct 16th – 19th.  There was greater than 350 courses, labs, and workshops given throughout the week.  It was impossible to make all of these great lectures, but I was able to take away some very important […]

Intensive Blood Pressure Control Doesn’t Benefit Patients with Acute Cerebral Hemorrhage (ATACH-2)

04 Aug
August 4, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: Hemorrhagic stroke accounts for only 11-22% of all strokes but up to 50% of all stroke mortality. Additionally, there is significant disability associated with the disease in survivors. Much of our attention in the Emergency Department (ED) is guided towards preventing expansion of bleeding and secondary injury after […]

The PATCH Trial: Hold the Platelets in Spontaneous Intracerebral Hemorrhage?

15 Jun
June 15, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: Hemorrhagic stroke accounts for 11 – 22% of strokes, half of all stroke deaths, and a significant amount of disability in many of the remaining survivors. Spontaneous, non-traumatic, intracerebral hemorrhage (ICH) accounts for 2/3 of hemorrhagic strokes; estimated at > 2 million ICHs each year. To date several […]

The ENCHANTED Trial: Is Low-Dose the Right Dose for Intravenous tPA in Acute Ischemic Stroke?

26 May
May 26, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: Despite continued debate on the efficacy of alteplase (tPA), it currently remains one of the major interventions directed at patients presenting with acute ischemic stroke. The current standard dose of the drug is 0.9 mg/kg given over 1 hour. It is unclear whether lower doses would be equally […]

Sensitivity of Early Brain CT to Exclude Aneurysmal Subarachnoid Hemorrhage

11 Feb
February 11, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: Headache accounts for approximately 2% of all ED visits. One of the most serious etiologies of headache is aneurysmal subarachnoid hemorrhage (SAH), which accounts for 4 – 12% of ED patients with thunderclap headache. There have been several studies in the past few years suggesting that in neurologically […]

Xanthochromia Detection: Visual Inspection vs. Spectrophotometry

25 Jan
January 25, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: Although non-contrast head CT (NCHCT) has near perfect sensitivity (98-100%) in detecting aneurysmal subarachnoid hemorrhage (SAH) when performed within 6 hours of headache onset, sensitivity declines after 6 hours. As a result of declining sensitivity, lumbar puncture (LP) continues to be part of the workup in suspected SAH. […]

Clinical Decision Instruments in Minor Head Trauma – New Orleans + Canadian Decision Instruments

18 Jan
January 18, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: CT scans are frequently done after minor head injury to evaluate for intracranial hemorrhage. While CT scans are an excellent tool for diagnosing or ruling out this disorder, they are not without harms including radiation exposure, cost and department delays. Much of the time, CTs are negative, or […]

Does a Normal Head CT Within 6 Hours of Onset of Headache Rule Out SAH?

07 Jan
January 7, 2016

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketBackground: The traditional standard workup for ruling out subarachnoid hemorrhage (SAH) has been a non-contrast head CT and, if negative, a lumbar puncture. The thought behind this is that the sensitivity of head CT to rule out SAH is not 100% and declines over time and missing a SAH […]

Ischemic Stroke Treatment Archive

09 Nov
November 9, 2015

Facebook Twitter Google+ Pinterest LinkedIn Reddit PocketI recently returned from the American College of Emergency Physicians (ACEP) Conference which took place from Oct. 26th – 29th, 2015 in Boston, MA.  There were really a lot of amazing talks by so many amazing speakers but one lecture in particular by David Newman, of SMART EM and […]

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