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Medical Category: Neurology

The ARAMIS Trial: DAPT vs Alteplase in Minor Nondisabling Acute Ischemic Stroke

Background: Current stroke guidelines recommend IV alteplase for patients with acute ischemic stroke presenting within 4.5hrs of symptom onset based on the NINDS and ECASS III publications. Both NINDS and ECASS III excluded patients with mild stroke symptoms but failed …

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Neurology

Andexxa Vs 4F-PCC in ICH: An Ongoing Debate

BACKGROUND: Direct oral anticoagulants (DOACs) such as rivaroxaban [Xarelto] and apixaban [Eliquis] have become more prevalent in the aging population and are associated with intracranial bleeding at rates up to 4.2%. (Xian 2019) 4-Factor Prothrombin Complex Concentrates (4F-PCC), or K-Centra, …

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NeurologyTrauma

External Validation of Pittsburgh Cardiac Arrest Category (PCAC) Illness Severity Score

Background Information: Multiple illness severity scores have been developed for use after out-of-hospital cardiac arrest (OHCA) and in-hospital cardiac arrest (IHCA). Unfortunately, these rely on information that is not immediately available to providers in the early hours following return of …

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CardiovascularNeurologyResuscitation

REBEL Core Cast 83.0 – Post-LP Headache

Take Home Points Post dural-puncture headache affects up to 30% of patients after lumbar puncture. Suspect PDPH in all patients who recently underwent an LP or epidural anesthesia regardless of whether they meet the IHS criteria. The best way to …

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NeurologyProcedures and Skills

Tenecteplase vs Alteplase in Acute Ischemic Stroke

Background: At my shop we have changed wholesale to the use of tenecteplase over alteplase for acute ischemic stroke meeting criteria for thrombolytic therapy.  This was based on a systematic review and meta-analysis of 6 RCTs and 2 observational trials …

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Neurology

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