Archive

Medical Category: Neurology

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

Background: 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 ...

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Neurology

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

Background: 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. ...

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Neurology

REBEL Cast Episode 21: Sensitivity of Early Brain CT to Exclude Aneurysmal Subarachnoid Hemorrhage

Background: 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 ...

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Neurology

Xanthochromia Detection: Visual Inspection vs. Spectrophotometry

Background: 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 ...

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Neurology

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

Background: 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 ...

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Neurology
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