Archive for category: Neurology

Is it Safe to Discharge Patients Home with Isolated Traumatic Subarachnoid Hemorrhage (itSAH)?

05 Jun
June 5, 2018

Background: I received a text message from one of my colleagues inquiring about discharging a patient home with isolated traumatic subarachnoid hemorrhage and to be honest I had heard about this practice, but was not completely aware of the literature around it.  Turns out from a PubMed search there was a meta-analysis published just this past […]

Tenecteplase versus Alteplase before Endovascular Therapy for Ischemic Stroke (EXTEND-IA TNK)

04 Jun
June 4, 2018

Background: Alteplase is a tissue plasminogen activator that is approved for use prior to thrombectomy in ischemic strokes with the goal of reperfusion to ischemic areas of the brain. Tenecteplase is a recombinant enzyme derived from alteplase that is more specific to fibrin and more resistant to inactivation by alteplase inhibitors. Tenecteplase is less expensive, […]

Cauda Equina Syndrome

31 May
May 31, 2018

Definition: Syndrome characterized by dysfunction of multiple lumbar and sacral nerve roots in the lumbar vertebral canal due to compression Anatomy The spinal cord terminates in the conus medullaris at the T12/L1 vertebral body in adults Cauda equina Collection of nerve roots from L1-S5 Compression from various causes results in lower motor neuron pathology

Wernicke Encephalopathy

14 May
May 14, 2018

Definition: Encephalopathy that occurs secondary to thiamine (vitamin B1) deficiency. While Wernicke encephalopathy is reversible with treatment, it can progress to the irreversible Korsakoff’s syndrome if left untreated.

Stroke Workflow in 2018

22 Apr
April 22, 2018

With the publication of the DAWN and DEFUSE-3 trials came a new era in stroke management.  We have discussed the specific literature pertaining to endovascular therapy on REBEL EM before in our 2hour CME activity HERE.  Along with the two new publications came the 2018 AHA/ASA guidelines for endovascular therapy in acute ischemic stroke.  Anand Swaminathan and myself […]