Neurohospitalist

Questions discussed in this category

Are there any clinical trials underway to study additional therapies?

Do you utilize thrombolytic therapy in patients with CRAO?

Do you recommend CT perfusion in patients presenting with symptoms of acute stroke before 6 hours?

What blood pressure targets do you enforce in the first 24-48 hours in a patient who develops an intracranial hemorrhage after mechanical thrombectomy?

Blood pressure targets for ischemic stroke and intracerebral hemorrhage are described in several guidelines. However, in patients with acute stroke wh...

2 Answers available

Would you discontinue romosozumab in a patient who develops a hemorrhagic stroke while on therapy?

5 Answers available

What is your approach to secondary stroke prevention in patients with atrial fibrillation and intracranial stenosis (>70%)?

4 Answers available

When do you recommend hyperacute MRI for patients with wake-up stroke?

2 Answers available

Would you recommend a CT venogram or MR venogram in patients with concern for venous sinus thrombosis?

1 Answer available

How does your treatment approach differ in patients with acute visual loss due to central retinal artery occlusion versus retinal vein occlusion?

2 Answers available

How do you approach management of patients with lupus and transverse myelitis not responding to pulse dose steroids?

3 Answers available

Do you typically load DAPT in patients with ICAD?

2 Answers available

How do you apply the 2HELPS2B score into clinical decision making for determining duration of cEEG testing?

1 Answer available

What imaging do you recommend for patients with suspected CSF leak?

2 Answers available

How would you determine the safety of anticoagulation in patients with evidence of cerebral microhemorrhages who present with acute stroke secondary to cardioembolism?

3 Answers available

Would you consider starting dual antiplatelet therapy in a patient with evidence of petechial hemorrhage post-stroke secondary to ICAD?

1 Answer available

What is the expected timeframe one would expect to see paroxysmal sympathetic hyperactivity/sympathetic storming persist post-traumatic brain injury?

For example, in the setting of TBI, how do you guide the duration of the medical treatment?

2 Answers available

Would you consider skipping intravenous thrombolysis in patients with tandem occlusions who qualify for endovascular thrombectomy?

1 Answer available

Is there a good rationale for using vasopressors/induced hypertension in a patient with fluctuating neurologic deficits from symptomatic intracranial stenosis?

3 Answers available

When do you consider stenting in patients with recurrent stroke with ICAD?

2 Answers available

What is the preferred approach to managing non-occlusive or partially occlusive venous sinus thrombosis?

1 Answer available

What is your approach to the management of asymptomatic intracranial atherosclerosis discovered during the workup of an acute stroke?

Does it influence your choice of antithrombotic therapy? Do you perform serial follow-up imaging?

3 Answers available

When do you consider patients with acute stroke with large vessel occlusion with very low ASPECTS scores (less than 3) for endovascular thrombectomy?

In light of meta-analysis data showing favorable outcomes in this normally excluded subset of patients (Katsanos et al., PMID 37775318).

1 Answer available

How would you manage a CVST secondary to a traumatic brain injury with the presence of intracranial hemorrhage?

When would you consider using anticoagulation and for how long?

4 Answers available

In which patients do you recommend craniectomy-watch after acute stroke?

2 Answers available

How often is a contrast-enhanced brain MRI truly normal in the setting of spontaneous intracranial hypotension?

I am aware that the radiological signs can be subtle or overlooked, or confused with a Chiari malformation, hence, I will typically review images with...

1 Answer available

What is your strategy for treating persistent headaches in the aftermath of subarachnoid hemorrhage?

Does your strategy change depending on whether or not it is a secured or unsecured aneurysmal SAH?

4 Answers available

What do you advise regarding the timing and safety of major surgery in patients with moderate to severe intracranial atherosclerosis?

Does your approach differ if the stenosis is symptomatic or flow-limiting?

1 Answer available

Would you recommend TNK or DAPT in patients with stroke-like symptoms and NIHSS less than 5 presenting within 4.5 hours?

4 Answers available

When is brain biopsy useful/warranted as part of the diagnostic work-up in patients with suspected primary CNS angiitis?

3 Answers available

Regarding CVST, what protocol of heparin dosing do you regularly use and does it change depending on clot burden/ICH status?

Is there any evidence supporting the use of heparin boluses?

2 Answers available

Would you administer IV thrombolysis in a patient presenting with disabling stroke symptoms while on anti-amyloid therapy?

4 Answers available

When do you use MRI to evaluate patients with spontaneous subdural hemorrhage?

In light of the evidence associating cerebral amyloid angiopathy (CAA) with subdural hemorrhage; Rivier et al., PMID 38147345.

1 Answer available

Do you typically use NOACs or Lovenox in patients with stroke due to hypercoagulability from malignancy?

1 Answer available

What is your treatment approach to neurological Sjogrens disease with both peripheral neuropathy and transverse myelitis?

1 Answer available

Do you repeat a lumbar puncture in a patient living with HIV diagnosed with and treated for neurosyphilis and if so, when?

1 Answer available

In patients being evaluated for brain death, which abnormal movements are definitively known to still be consistent with brain death and which are possibly consistent with brain death but lack definitive evidence?

What are the sources for this and are they reliable by today’s standards? Numerous case series report various abnormal movements but how reliabl...

1 Answer available

In a patient with presumed autoimmune encephalitis, would treating them with IVIG before getting a brain biopsy alter the pathological changes in a meaningful way?

2 Answers available

When do you re-image patients with a diagnosis of venous sinus thrombosis?

2 Answers available

What is your approach to monitoring the neurologic status of a patient with a traumatic brain injury requiring burst suppression for status epilepticus?

E.g., a patient has an intracranial hemorrhage after TBI with convulsive status epilepticus.

1 Answer available

How do you manage patients with status dystonicus?

1 Answer available

When do you consider treating intracerebral hemorrhage associated with cerebral amyloid angiopathy as an inflammatory CAA?

How would you treat it?

1 Answer available

Is there a role for routine EEG in the diagnostic evaluation of critically ill comatose patients or should these patients always receive long-term continuous video EEG monitoring?

How does the 2HELPS2B scoring tool play a role in your decision-making?

1 Answer available

How do you approach patients with recurrent TGA in the emergency room?

1 Answer available

How do you manage incidentally found venous sinus thrombosis?

5 Answers available

Would you consider dual antiplatelet therapy for stroke prevention for ICAD in patients with a history of SAH?

2 Answers available

What criteria are used to choose a specific dose of aspirin in ischemic stroke?

We have seen 81 vs 162 vs 325 mg up to 1300 mg.

3 Answers available

Would you give TNK or IVT to a patient with proximal occlusion and an NIHSS of 0-3 (non-disabling)?

How about a distal occlusion? The patient was initially symptomatic but symptoms improved or mostly resolved.

5 Answers available

How many times one can use IVIG in GBS?

Plasmapheresis first or IVIG first in GBS? What other treatment options are there for severe disabling GBS?

1 Answer available

What is the normal range of spinal tap opening pressure?

Are there variations with different patient populations?

3 Answers available

How do you prescribe ketamine for treatment of refractory status epilepticus, and what is its efficacy?

1 Answer available

Is there a role for inpatient EMG/NCS in patients who present with rhabdomyolysis with unclear etiology?

1 Answer available

How do you acutely manage a free-floating thrombus in a major artery in a patient with a stroke as a result of it?

4 Answers available

How do you work up incidentally found papilledema in the emergency room?

2 Answers available

Would you attempt a brain MRI in patients who present to the ER with subacute presentation of obstructive hydrocephalus?

Given the risk of elevated ICP, would you attempt a brain MRI to further characterize the lesion? Or would CT imaging suffice prior to intervention?

1 Answer available

Do you start an anti-seizure medication in a patient with a first unprovoked nocturnal seizure with a normal exam, imaging, and EEG; or wait until the second seizure?

11 Answers available

Which patients presenting with spontaneous ICH should be considered for a diagnostic cerebral angiogram/DSA?

1 Answer available

How do you counsel patients with postmedian sternotomy plexopathy?

1 Answer available

What would be the clinical benefit of multiphase CTA over CTP?

Should MTCTA be standard for anyone with LKN>=6h?

4 Answers available

Does management of NMDA receptor encephalitis change in a patient with HIV/AIDS?

1 Answer available

How would you work up and manage an isolated CN3 deficit with anisocoria?

MRI Orbits with possible mild enhancement of unilateral CN3; Brain MRI chronic microvascular disease, mild atrophy.

2 Answers available

Is there a utility in getting repeat antibody testing on GBS patients after PLEX?

Can this guide further treatment/prognosis?

1 Answer available

When should one consider obtaining a cardiac MRI in ischemic stroke patients?

What is the utility of it?

1 Answer available

How do you approach the management of EBV Meningoencephalitis (CSF pleocytosis and CSF PCR positive for EBV)?

3 Answers available

When do you restart antiplatelet therapy in patients with hemorrhagic conversion of stroke?

2 Answers available

Do you think repeated routine EEG is sufficient for cardiac arrest patients or should we be always using continuous EEG?

Many recent studies cast doubt on continuous vs repeated routine EEG.

1 Answer available

When do you consider plasmapheresis instead of (or in addition to) IV steroids for patients with acute MS exacerbation?

1 Answer available

What are some commonly missed diagnoses that should be considered in cases of otherwise seronegative yet steroid-responsive autoimmune encephalitis?

2 Answers available

What workup do you recommend on patients with suspected ischemic cranial nerve six palsy?

1 Answer available

For patients with acute ischemic stroke and BP >185/110, at what point do you consider persistently elevated BP too refractory to safely give thrombolysis?

Current guidelines (AHA, ESO, etc.) are not clear. In addition, if a patient arrives with BP>240 how do you balance the risk of hypoperfusion with ...

4 Answers available

What is the recommended approach for extracranial bleeding after tPA?

Fibrinogen level >200.

2 Answers available

For patients with ischemic stroke status-post decompressive hemi-craniectomy, when should they start aspirin for secondary stroke prevention?

For patients with ischemic stroke status-post decompressive hemi-craniectomy, when should they start aspirin for secondary stroke prevention? POD 5? P...

2 Answers available

Is intracranial hemorrhage a contraindication for valproic acid?

1 Answer available

How do you manage patients with post spinal tap headaches?

Are there any diagnostic tests or imaging that you recommend?

3 Answers available

How do you approach a patient with atrial fibrillation on apixaban who has a new cardioembolic stroke?

3 Answers available

In patients with Afib on anticoagulation and concurrent intracranial atherosclerotic disease, would you consider adding an anti-platelet to anticoagulation if there are recurrent events that could be related to the ICAD?

1 Answer available

How do you manage and treat post stroke alien hand syndrome?

1 Answer available

In patients with embolic stroke and a PFO, how often do you go beyond venous Doppler of the lower extremities to screen for DVT (e.g. MRV or CTV abdomen and pelvis)?

Would you anticoagulate if this screening is negative pending PFO closure?

1 Answer available

When can you utilize external ventricular drains (EVDs) in the management of posterior fossa strokes?

Do all malignant posterior fossa infarcts need sub-occipital craniectomy or are there a subset of cases that can be managed with EVD?

1 Answer available

Do you typically recommend anti-epileptic medication in patients with acute multi-compartmental intracranial hemorrhage?

1 Answer available

What is your approach to the management of worsening dystonic spasms that are painful and refractory to standard dystonia medications?

In a patient who is already on a standing regimen of baclofen, tizanidine, trihexyphenidyl, clonidine, and diazepam and who is taking additional diaze...

2 Answers available

Is there a difference in treatment of status epilepticus from alcohol withdrawal vs other causes?

1 Answer available

Is there a role for using an external ventricular drain (EVD) trial in the workup of normal pressure hydrocephalus?

This applies to using EVD either in addition to or instead of a large volume lumbar puncture.

1 Answer available

What is the diagnostic yield of working up suspected autoimmune encephalitis in patients with new onset behavioral disturbance without overt neurological deficits?

Anecdotally, the diagnostic yield in these patients seems quite low, yet autoimmune encephalitis is often invoked in such patients, particularly in th...

1 Answer available

What are some alternatives to dexamethasone for brain edema in patients who are allergic, have an intolerance, or refuse the medication?

5 Answers available

How do you manage autonomic storming in patients with increased intracranial pressure?

1 Answer available

Under which clinical scenarios do you consider an inpatient EMG?

1 Answer available

How do you target therapy before the EEG is connected in a patient who comes to the ED in super refractory generalized convulsive status epilepticus once the convulsions resolve?

If the patient is in burst-suppression once EEG is connected, how long do you keep patient in burst-suppression before weaning sedation?

1 Answer available

What blood pressure goals do you typically target for patients in the immediate post thrombectomy period?

2 Answers available

Do you perform apnea testing prior to ancillary tests in patients with suspected brain death who are unable to undergo complete brainstem testing?

For patients who are unable to have complete brain stem testing, would you recommend apnea testing prior to ancillary tests in case of suspected brain...

2 Answers available

Do you consider a severe ICA stenosis (70-99% narrowing per NASCET criteria) symptomatic if a lacunar stroke attributable to small vessel disease occurs in the perforating arteries (e.g. lenticulostriate) downstream from the stenosis?

Do you offer this person a vascular intervention (i.e., CEA or stenting)?

1 Answer available

How do you approach treatment of myoclonic status epilepticus from anoxic brain injury?

Or love to share personal experiences/articles?

3 Answers available

Is there a role to continue aspirin in patients with myeloproliferative disorders who have never had a thrombotic event that are starting DOAC for stroke prophylaxis with newly diagnosed atrial fibrillation?

2 Answers available

How long do you wait before foley or IV placement in patients who have recieved TNK or TPA?

3 Answers available

What are current strategies to treat severe symptomatic basilar stenosis failing medical therapy?

2 Answers available

How do you manage patients with a diagnosis of AIDP who do not respond to initial IVIg?

3 Answers available

How do you complete brain death testing in patients who cannot tolerate apnea testing and are unable to transport for ancillary testing?

For instance, if the patient doesn’t tolerate apnea testing, is too unstable to go for ancillary testing outside the ICU, and TCDs/EEG are unava...

5 Answers available

Can Guillain-Barre syndrome present with intact reflexes?

3 Answers available

When do you recommend treating stimulus-induced generalized periodic discharges (GPDs)?

1 Answer available

What antithrombotic regimen do you recommend prior to and in anticipation of CEA for patients with symptomatic carotid stenosis?

2 Answers available

Would you give IV thrombolysis to a patient presenting with acute disabling stroke symptoms after a TAVI procedure?

1 Answer available

When do you start anticoagulation in patients with endocarditis and evidence of mycotic aneursym?

3 Answers available

Do you typically recommend four factor prothrombin complex concentrate versus fresh frozen plasma for INR correction in patients with vitamin K antagonist associated spontaneous ICH?

4 Answers available

How do you approach ictal-interictal continuum in patients with presumed toxic/metabolic etiology?

For example, a patient with 2 Hz GPDs with hepatic or uremic encephalopathy.

1 Answer available

Is angioedema secondary to IV tPA considered an absolute contraindication for tPA in future?

3 Answers available

When are steroids indicated in the treatment of strep pneumo meningitis?

Does timing relative to initiation of antibiotics matter?

1 Answer available

In what clinical situations do you treat triphasic waves on EEG?

What are some high-yield instances where triphasic waves on electroencephalogram (EEG) are more than just harmless markers of gross toxic-metabolic en...

2 Answers available

When would you add acyclovir for treatment of Bell's Palsy in addition to steroids and symptomatic care?

1 Answer available

How do you evaluate and treat patients with cerebral edema secondary to hyperammonemia?

What modality do you prefer?

3 Answers available

Do you recommend pre-emptive anti-epileptic treatment for patients with spontaneous ICH?

If so, for how long?

3 Answers available

Would you favor restarting anticoagulation or pursuing left atrial appendage closure in a patient with hemorrhagic stroke on anticoagulation for non-valvular atrial fibrillation?

3 Answers available

In what subset of traumatic brain injury/concussion patients would you consider use of N-Acetyl Cysteine?

2 Answers available

When do you redose IVIG in GBS patients who were under-treated and are worsening?

Is there any data supporting this?

2 Answers available

How do you approach the workup of a patient with incidentally found pachymeningitis?

1 Answer available

What factors influence whether you treat a suspected flare of NMOSD (neuromyelitis optica spectrum disorder) with pulse dose steroids versus plasmaphereis?

1 Answer available

What is your practice for the timing of resumption of oral anticoagulation after ICH?

Do you order any imaging beforehand? Are there other studies that you order?

1 Answer available

What symptomatic management do you recommend in patients with post LP headaches?

When do you consider a blood patch?

1 Answer available

Under what circumstances would you recommend using the 2HELPS2B score to decide whether or not to pursue long-term cEEG?

While it is an excellent score for objectively assessing concerning EEG features, there are pathologies where it can be argued that long-term monitori...

1 Answer available

Do you typically recommend platelet transfusions in patients with spontaneous ICH?

Do you have a particular cutoff?

2 Answers available

What is the utility and yield of CSF studies for orbital apex syndrome?

Although probably more familiar to ophthalmologists, orbital apex syndrome refers to the consequence of any kind of swelling or mass effect within the...

1 Answer available

When do you recommend MRA in patients with spontaneous ICH and negative CTA?

Do you ever recommend any specific sequences on MRA?

3 Answers available

Do you typically recommend CT angiogram and CT venogram to assess for patients with lobar spontaneous ICH?

2 Answers available

How do you approach a mildly positive finding on an autoimmune encephalitis panel when there is no other evidence of encephalitis (such as elevated CSF protein, abnormal imaging, or EEG findings)?

For example, a GAD65 Ab of 0.07 when the cut-off is 0.02. Does this answer change if you consider adult vs pediatric populations?

2 Answers available

For a patient with high suspicion for NMDA receptor encephalitis, is there a role for giving rituximab along with methylprednisolone & IVIG (all three together) while the CSF anti-NMDAR antibodies are still pending?

Instead of waiting for the antibody test to result, if you have a high suspicion for NMDAR encephalitis, is there a role for giving rituximab alongsid...

1 Answer available

Do you always pursue stroke work up in patients diagnosed with transient global amnesia?

For patients clinically presenting with Transient Global Amnesia and no other focal neurologic deficits, do you always pursue work up to rule out stro...

8 Answers available

What is your decision process on decreasing the sodium goal for patients with cerebral edema?

1 Answer available

Would you consider anticoagulation for a young patient with a recent embolic stroke and newly diagnosed global cardiac hypokinesis with ejection fraction of less than 25%?

No thrombus detected on echocardiogram and no evidence of atrial fibrillation is present.

1 Answer available

When do you prescribe a steroid taper after the high dose IV course for a multiple sclerosis exacerbation?

3 Answers available

Would you recommend short-term dual antiplatelet therapy for a patient who received tPA, and is otherwise eligible for dual antiplatelet therapy per POINT or SAMMPRIS trial?

3 Answers available

Do you counsel patients against driving who presents with transient global amnesia?

1 Answer available

What is your approach for a patient with an acute ischemic stroke caused by an aortic thrombus?

2 Answers available

For patients with generalized tonic-clonic seizures lasting > 2 minutes without IV access, what alternative medications can be used?

1 Answer available

Do you routinely obtain an EEG in patients who are admitted with traumatic intra-cerebral hemorrhage?

3 Answers available

How do you manage acute exacerbations of trigeminal neuralgia?

What effective modalities have you found for acute exacerbations of trigeminal neuralgia including in patients who present to the ED?

3 Answers available

How do you decide between TCAR vs. carotid stenting for patients unstable for CEA?

2 Answers available

How do you approach the treatment of SREAT (steroid-responsive encephalopathy with autoimmune thyroiditis) after initial pulse dose steroids?

1 Answer available

When do you start anticoagulation in a patient with cardioembolic CVA secondary to new onset atrial fibrillation with hemorrhagic conversion?

1 Answer available

How do you determine timing and frequency of stability scans for a patient with spontaneous, non-aneurysmal intracerebral hemorrhage?

What factors influence your thinking?

1 Answer available

When do you use plasmapheresis after IVIG in patients with Guillain-Barre Syndrome?

4 Answers available

Do you frequently encounter asterixis in patients with UTI associated encephalopathy?

The most frequently taught cause of asterixis is hepatopathy and of course hepatic encephalopathy, and has other close associations (ie, uremia), I ha...

2 Answers available

Do you use a combination of anticoagulant and antiplatelet therapy for treating intraluminal internal cerebral artery thrombus causing stroke?

For what duration do you use therapy?

1 Answer available

How do you approach the management of a large vessel stroke if you anticipate the development of malignant cerebral edema?

Is there any benefit to starting hyperosmolar therapy prior to the development of depressed level of consciousness or midline shift?

1 Answer available

Do you treat cerebral vein thrombosis with parenchymal hemorrhage using full dose heparin protocol rather than the high risk protocol?

1 Answer available

Do you start anticoagulation in a patient with infective endocarditis who also has atrial fibrillation and stroke?

1 Answer available

How would you approach evaluation and treatment of a patient on pembrolizumab therapy who presents with symmetric, proximal, upper extremity and lower extremity painful weakness without an elevated CK?

1 Answer available

How do you treat refractory focal status epilepticus in patients with traumatic bilateral subdural hematomas?

How do you treat refractory focal status epilepticus in an adult with history of alcoholism and traumatic bilateral subdural hematomas who is failing ...

1 Answer available

Do you always perform temporal artery biopsy in patients with positive inflammatory markers and high clinical suspicion of GCA?

2 Answers available

Is either ESR or CRP more sensitive or specific for the diagnosis of GCA?

Additionally, what is the current role for temporal artery ultrasound in workup for GCA?

3 Answers available

How would you approach treatment of a brainstem AVM after hemorrhage in a patient not a candidate for surgery or embolization?

What would be your preferred technique and dose/fractionation?

2 Answers available

How do you treat post-IVIG headache that is not responsive to Tylenol or NSAIDs?

Specifically, how do you treat the delayed headache, not the headache that develops during the infusion where pre-hydration and slowing down the rate ...

4 Answers available

What is the utility in repeating a temporal ultrasound (US) in a previously US diagnosed positive GCA patient who has received treatment and is presenting with recurrent GCA symptoms?

1 Answer available

For patients with atrial fibrillation on DOAC, when should they resume DOAC after a thalamic bleed without intraventricular bleed?

How does presence of intraventricular hemorrhage change your recommendations?

2 Answers available

What is the best course of action for a patient with isolated carcinomatous meningitis who is responding well to intrathecal methotrexate but now has MRI findings suspicious for methotrexate leukoencephalopathy?

Can intrathecal methotrexate be continued with close neurologic observation vs switch in treatment now due to findings?

1 Answer available

How do you approach patients with suspected CNS lymphoma who have been treated with steroids?

Do you biopsy immediately, stop treatment, biopsy at a later time, or depend solely on the data you already have?

1 Answer available

When is follow-up imaging warranted in patients with anoxic brain injury?

What modality do you prefer?

1 Answer available

What DHE migraine protocol works best for acute treatment both in terms of dosage and timeframe?

1 Answer available

When do you consider middle meningeal artery embolization in patients with recurrent subdural hemorrhages?

In what clinical scenario would you refer a patient for embolization? Are there any contraindications?

1 Answer available

At what timepoint do you do an EMG/NCS in patients with suspected GBS?

How long do you wait (from onset of symptoms) to do a EMG/NCS in a patient with GBS?

1 Answer available

How to you treat pregnant women who develop Bell's Palsy?

1 Answer available

In a patient with suspected Miller Fisher syndrome, would you wait until antibody testing results to start IVIG or treat empirically?

Is there is a particular pattern of extraocular motility restriction in Miller Fisher syndrome?

1 Answer available

How do you treat patients with symptoms of acute ischemic stroke who have an allergic reaction to alteplase?

How would you treat patients with symptoms of AIS who have an allergic reaction to TPA with no evidence of large vessel occlusion on imaging? What nex...

1 Answer available

When do you start anticoagulation for secondary prevention in patients with HFrEF and history of embolic strokes?

For a relatively young, medically compliant patient with HFrEF (EF<35%) and h/o embolic stroke, what is the consensus of starting AC for secondary ...

1 Answer available

In women of childbearing age with NMDA encephalitis and normal pelvic imaging, is there a role for oophorectomy for possible microteratoma?

If not, how often do you repeat pelvic imaging?

1 Answer available

In patients in the ICU who are on the inter-ictal continuum, how do you decide whether or not to treat for potential non-convulsive status epilepticus?

In patients undergoing continuous EEG monitoring in the ICU, we often encounter EEG patterns that lie along the inter-ictal continuum (IIC). In such c...

1 Answer available

When do you restart anticoagulation in patients with atrial fibrillation who just had an ischemic stroke?

1 Answer available

When do you consider starting hypertonic saline solution in patients with an acute ischemic stroke?

1 Answer available

How do you approach management of cerebral venous sinus thrombosis in a patient with severe thrombocytopenia?

1 Answer available

Is an EMG/NCS required to clinically diagnose Guillain barre syndrome?

1 Answer available

Should patients who have had hemorrhagic strokes be restarted on oral anticoagulation?

If so, how do you decide when to restart anticoagulants?

1 Answer available

How do you determine the timing of anticoagulation for patients with large MCA strokes secondary to atrial fibrillation?

1 Answer available

In what clinical settings is acute ICH clot removal recommended?

1 Answer available

In patients with recurrent ischemic infarcts on the same side as an internal carotid artery lesion, is intervention warranted even if there is less than 50% obstruction?

When would you consider stenting or CEA even if there is less than 50 obstruction when no other etiology has been found?

1 Answer available

Do you treat HIV/AIDS-associated CNS vasculitis with antiretrovirals alone or in combination with steroids?

1 Answer available

Papers discussed in this category

Stroke, 2020 Aug 06

Anticoagulation Type and Early Recurrence in Cardioembolic Stroke: The IAC Study.

Neurology. Clinical practice, 2018-02

Anticoagulation for atrial fibrillation after intracranial hemorrhage: A systematic review.

Stroke, 2015 May 28

Guidelines for the Management of Spontaneous Intracerebral Hemorrhage: A Guideline for Healthcare Professionals From the American Heart Association/American Stroke Association.

Lancet Neurol, 2022 09

Safety and efficacy of prophylactic levetiracetam for prevention of epileptic seizures in the acute phase of intracerebral haemorrhage (PEACH): a randomised, double-blind, placebo-controlled, phase 3 trial.

Stroke, 2022 May 17

2022 Guideline for the Management of Patients With Spontaneous Intracerebral Hemorrhage: A Guideline From the American Heart Association/American Stroke Association.

Stroke, 2019-02

Ischemic Stroke and Internal Carotid Artery Web.

Stroke, 2011-04

Diagnosis and management of cerebral venous thrombosis: a statement for healthcare professionals from the American Heart Association/American Stroke Association.

Ann Neurol, 2020 Aug 05

Anticoagulation Timing in Cardioembolic Stroke and Recurrent Event Risk.

Neurotherapeutics,

The Medical Management of Cerebral Edema: Past, Present, and Future Therapies.

Lancet Neurol, 2017 Sep

Paroxysmal sympathetic hyperactivity: the storm after acute brain injury.

Archives of neurology, 2009-06

Ganglionic acetylcholine receptor autoantibody: oncological, neurological, and serological accompaniments.

Muscle & nerve, 2013-04

Striational antibodies in a paraneoplastic context.

Muscle & nerve, 2016-08

P/Q- and N-type calcium-channel antibodies: Oncological, neurological, and serological accompaniments.

Muscle & nerve, 2017-07

GAD65 neurological autoimmunity.

Annals of neurology, 2017-07

Expanded phenotypes and outcomes among 256 LGI1/CASPR2-IgG-positive patients.

J Neurol, 2021 Jul 17

Frequency of silent brain infarction in transient global amnesia.

Headache, 1990-05

Repetitive intravenous DHE in the treatment of refractory headache.

Neurology, 1986-07

Repetitive intravenous dihydroergotamine as therapy for intractable migraine.

Headache, 1997-03

Continuous intravenous dihydroergotamine in the treatment of intractable headache.

J Pain Res, 2020 Apr 30

Updated Evaluation of IV Dihydroergotamine (DHE) for Refractory Migraine: Patient Selection and Special Considerations.

Headache, 2010 Jan 28

Outpatient home-based continuous intravenous dihydroergotamine therapy for intractable migraine.

J Vasc Surg, 2019 Dec 31

Duration of blood flow reversal during transcarotid artery revascularization does not affect outcome.

The New England journal of medicine, 2012-05-17

Warfarin and aspirin in patients with heart failure and sinus rhythm.

The New England journal of medicine, 2018-10-04

Rivaroxaban in Patients with Heart Failure, Sinus Rhythm, and Coronary Disease.

The New England journal of medicine, 2019-05-16

Dabigatran for Prevention of Stroke after Embolic Stroke of Undetermined Source.

Heart, 2019 Apr 08

Anticoagulation therapy in heart failure and sinus rhythm: a systematic review and meta-analysis.

Seminars in arthritis and rheumatism, 2012-06

Utility of erythrocyte sedimentation rate and C-reactive protein for the diagnosis of giant cell arteritis.

Arthritis Rheumatol, 2021 Jul 08

2021 American College of Rheumatology/Vasculitis Foundation Guideline for the Management of Giant Cell Arteritis and Takayasu Arteritis.

Ann Rheum Dis, 2019 Jul 03

2018 Update of the EULAR recommendations for the management of large vessel vasculitis.

Continuum (Minneap Minn),

Guillain-Barré Syndrome.

Obstet Gynecol Surv,

Bell's Palsy in Pregnancy.

Mayo Clin Proc,

My Treatment Approach to Giant Cell Arteritis.

J Clin Neurophysiol,

American Clinical Neurophysiology Society's Standardized Critical Care EEG Terminology: 2021 Version.

Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 2016-02

Generalized periodic discharges and 'triphasic waves': A blinded evaluation of inter-rater agreement and clinical significance.

J Clin Neurophysiol,

Atypical or Typical Triphasic Waves-Is There a Difference? A Review.

Neurology, 2019 Jan 11

RCVS score and diagnostic approach for reversible cerebral vasoconstriction syndrome.

The Lancet. Neurology, 2016-05

Neurological prognostication of outcome in patients in coma after cardiac arrest.

Postgrad Med J,

Post lumbar puncture headache: diagnosis and management.

Anesth Essays Res,

Role of Oral Prednisolone in the Management of Postdural Puncture Headache after Spinal Anesthesia in Urological Patients.

Journal of clinical oncology : official journal of the American Society of Clinical Oncology, 1993-03

Randomized prospective comparison of intraventricular methotrexate and thiotepa in patients with previously untreated neoplastic meningitis. Eastern Cooperative Oncology Group.

Neurosurgery,

Fractionated stereotactic radiotherapy for the treatment of large arteriovenous malformations with or without previous partial embolization.

Ann Rheum Dis, 2021 Jul 02

Ultrasound halo sign as a potential monitoring tool for patients with giant cell arteritis: a prospective analysis.

Tremor and other hyperkinetic movements (New York, N.Y.), 2014

Pathophysiology and treatment of alien hand syndrome.

J Rehabil Med Clin Commun, 2021 Feb 24

Rehabilitation of a Patient with Alien Hand Syndrome: a Case Report of a 61-Year Old Man.

Stroke, 2021 May 24

2021 Guideline for the Prevention of Stroke in Patients With Stroke and Transient Ischemic Attack: A Guideline From the American Heart Association/American Stroke Association.

eNeurologicalSci, 2017 Aug 02

Successful systemic thrombolysis with rtPA in a patient with history of a life-threatening rtPA-associated orolingual angioedema.

Neurol Clin Pract,

Thrombolysis of a stroke patient with history of rtPA-associated angioedema.

Journal of clinical neuromuscular disease, 2010-12

Plasma exchange after initial intravenous immunoglobulin treatment in Guillain-Barré syndrome: critical reassessment of effectiveness and cost-efficiency.

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Randomised trial of plasma exchange, intravenous immunoglobulin, and combined treatments in Guillain-Barré syndrome. Plasma Exchange/Sandoglobulin Guillain-Barré Syndrome Trial Group.

Lancet Neurol, 2021 Mar 17

Second intravenous immunoglobulin dose in patients with Guillain-Barré syndrome with poor prognosis (SID-GBS): a double-blind, randomised, placebo-controlled trial.

Ann Neurol,

Pharmacokinetics of intravenous immunoglobulin and outcome in Guillain-Barré syndrome.

Eur J Neurol, 2017 Aug 20

European Stroke Organization guideline for the diagnosis and treatment of cerebral venous thrombosis - endorsed by the European Academy of Neurology.

Cancer, 2011 Feb 01

Boswellia serrata acts on cerebral edema in patients irradiated for brain tumors: a prospective, randomized, placebo-controlled, double-blind pilot trial.

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Determination of Brain Death/Death by Neurologic Criteria: The World Brain Death Project.

Stroke, 2016 Dec 20

Optimal Timing of Anticoagulant Treatment After Intracerebral Hemorrhage in Patients With Atrial Fibrillation.

Stroke, 2010 Oct 28

Optimal timing of resumption of warfarin after intracranial hemorrhage.

J Thromb Haemost, 2010 Apr 08

Management of anticoagulation following central nervous system hemorrhage in patients with high thromboembolic risk.

Lancet Neurol, 2021 Sep 03

Effects of oral anticoagulation for atrial fibrillation after spontaneous intracranial haemorrhage in the UK: a randomised, open-label, assessor-masked, pilot-phase, non-inferiority trial.

The New England journal of medicine, 2018-07-19

Clopidogrel and Aspirin in Acute Ischemic Stroke and High-Risk TIA.

N Engl J Med, 2013 Jun 26

Clopidogrel with aspirin in acute minor stroke or transient ischemic attack.

Headache, 2020 Sep 27

Trigeminal Neuralgia Crisis - Intravenous Phenytoin as Acute Rescue Treatment.

Cephalalgia, 2022 Apr 25

Intravenous fosphenytoin as treatment for acute exacerbation of trigeminal neuralgia: A prospective systematic study of 15 patients.

Cephalalgia, 2022 Apr 26

Intravenous lacosamide and phenytoin for the treatment of acute exacerbations of trigeminal neuralgia: A retrospective analysis of 144 cases.

Archives of ophthalmology (Chicago, Ill. : 1960), 1988-08

The Optic Neuritis Treatment Trial.

Circulation, 2009-03-31

Randomized trial of warfarin, aspirin, and clopidogrel in patients with chronic heart failure: the Warfarin and Antiplatelet Therapy in Chronic Heart Failure (WATCH) trial.

Cerebrovascular diseases (Basel, Switzerland), 2014

Recurrent stroke in the warfarin versus aspirin in reduced cardiac ejection fraction (WARCEF) trial.

JAMA Neurol,

Left Ventricular Dysfunction Among Patients With Embolic Stroke of Undetermined Source and the Effect of Rivaroxaban vs Aspirin: A Subgroup Analysis of the NAVIGATE ESUS Randomized Clinical Trial.

Neurology, 2011-01-18

Evidence-based guideline update: Plasmapheresis in neurologic disorders: report of the Therapeutics and Technology Assessment Subcommittee of the American Academy of Neurology.

The Lancet. Neurology, 2016-04

A clinical approach to diagnosis of autoimmune encephalitis.

Lancet, 2016 May 10

Platelet transfusion versus standard care after acute stroke due to spontaneous cerebral haemorrhage associated with antiplatelet therapy (PATCH): a randomised, open-label, phase 3 trial.

J Neurol Neurosurg Psychiatry, 2016 May 13

Early blood pressure lowering in patients with intracerebral haemorrhage and prior use of antithrombotic agents: pooled analysis of the INTERACT studies.

J Am Heart Assoc, 2021 Feb 15

Outcomes in Antiplatelet-Associated Intracerebral Hemorrhage in the TICH-2 Randomized Controlled Trial.

Neurology, 2010 Sep 08

Prior antiplatelet therapy and outcome following intracerebral hemorrhage: a systematic review.

Lancet Infect Dis, 2004 Mar

Steroids in adults with acute bacterial meningitis: a systematic review.

Cochrane Database Syst Rev, 2015 Sep 12

Corticosteroids for acute bacterial meningitis.

Lancet Neurol, 2010 Feb 03

Adjunctive dexamethasone in bacterial meningitis: a meta-analysis of individual patient data.

Clin Neurol Neurosurg, 2021 Jan 19

Clinical significance of Epstein-Barr virus in the cerebrospinal fluid of immunocompetent patients.

BMC Infect Dis, 2011 Oct 21

Clinical characteristics of patients with Epstein Barr virus in cerebrospinal fluid.

Biomedicine & pharmacotherapy = Biomedecine & pharmacotherapie, 2021 Nov 12

Lessons from Epstein-Barr virus DNA detection in cerebrospinal fluid as a diagnostic tool for EBV-induced central nervous system dysfunction among HIV-positive patients.

The New England journal of medicine, 2018-02-15

Edoxaban for the Treatment of Cancer-Associated Venous Thromboembolism.

N Engl J Med, 2020 Mar 29

Apixaban for the Treatment of Venous Thromboembolism Associated with Cancer.

N Engl J Med, 2003 Jul 10

Low-molecular-weight heparin versus a coumarin for the prevention of recurrent venous thromboembolism in patients with cancer.

Stroke, 2013-10

Thrombolysis for ischemic stroke associated with infective endocarditis: results from the nationwide inpatient sample.

Stroke, 2016-01

Dynamic Angiographic Nature of Cerebral Mycotic Aneurysms in Patients With Infective Endocarditis.

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2019-08

Acute Ischemic Stroke Therapy in Infective Endocarditis: Case Series and Systematic Review.

Journal of the neurological sciences, 2019-08-15

Clinical course of infectious intracranial aneurysm undergoing antibiotic treatment.

JAMA, 2018-07-10

Effect of Alteplase vs Aspirin on Functional Outcome for Patients With Acute Ischemic Stroke and Minor Nondisabling Neurologic Deficits: The PRISMS Randomized Clinical Trial.

European stroke journal, 2017 Nov 29

Minor stroke due to large artery occlusion. When is intravenous thrombolysis not enough? Results from the SITS International Stroke Thrombolysis Register.

Frontiers in neurology, 2021 Sep 07

Treatment Challenges in Acute Minor Ischemic Stroke.

Brain, 2013 Oct 26

Diagnosis of Guillain-Barré syndrome and validation of Brighton criteria.

JAMA neurology, 2020 Aug 01

Effect of Endovascular Treatment With Medical Management vs Standard Care on Severe Cerebral Venous Thrombosis: The TO-ACT Randomized Clinical Trial.

Stroke, 2023 Sep 07

Study of Rivaroxaban for Cerebral Venous Thrombosis: A Randomized Controlled Feasibility Trial Comparing Anticoagulation With Rivaroxaban to Standard-of-Care in Symptomatic Cerebral Venous Thrombosis.

Anesth Pain Med (Seoul), 2022 Jan 18

Recent update on epidural blood patch.

Stroke, 2019-04

WEAVE Trial: Final Results in 152 On-Label Patients.

J Neurointerv Surg, 2020 Jun 19

The WOVEN trial: Wingspan One-year Vascular Events and Neurologic Outcomes.

J Int Med Res, 2017 Jan 25

Digestive and urologic hemorrhage after intravenous thrombolysis for acute ischemic stroke: Data from a Chinese stroke center.

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Clinical utility of electrodiagnostic studies in the inpatient setting.

J Neurol Sci, 2020 Jul 24

Time to diagnosis and factors affecting diagnostic delay in amyotrophic lateral sclerosis.

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Idiopathic normal pressure hydrocephalus: historical context and a contemporary guide.

The Canadian journal of neurological sciences. Le journal canadien des sciences neurologiques, 2021 Oct 14

Validity of ICD-10 Codes for Cerebral Venous Thrombosis Depends on Clinical Context.

Ann Neurol, 2017 Jul 19

Time-dependent risk of seizures in critically ill patients on continuous electroencephalogram.

Lancet, 2022 Oct 28

Intensive blood pressure control after endovascular thrombectomy for acute ischaemic stroke (ENCHANTED2/MT): a multicentre, open-label, blinded-endpoint, randomised controlled trial.

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Intensive blood-pressure lowering in patients with acute cerebral hemorrhage.

The Lancet. Neurology, 2007 Mar

Early decompressive surgery in malignant infarction of the middle cerebral artery: a pooled analysis of three randomised controlled trials.

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Dual antiplatelet therapy in stroke and ICAS: Subgroup analysis of CHANCE.

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Ticagrelor and Aspirin or Aspirin Alone in Acute Ischemic Stroke or TIA.

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Does continuous EEG influence prognosis in patients after cardiac arrest?

Clinical neurophysiology : official journal of the International Federation of Clinical Neurophysiology, 2022 Apr 18

EEG recording latency in critically ill patients: Impact on outcome. An analysis of a randomized controlled trial (CERTA).

Blood, 2020 Jun 18

Tocilizumab in patients with symptomatic Kaposi sarcoma herpesvirus-associated multicentric Castleman disease.

General thoracic and cardiovascular surgery, 2022 Jul 25

Brachial plexus injury and upper rib fracture after median sternotomy in cardiac surgery.

Interactive cardiovascular and thoracic surgery, 2007 Jan 04

Brachial plexus injury following median sternotomy.

Neurology, 2020 Sep 01

Ketamine to treat super-refractory status epilepticus.

Lancet (London, England), 2018-08-04

Effects of aspirin on risks of vascular events and cancer according to bodyweight and dose: analysis of individual patient data from randomised trials.

JAMA, 2023 Jun 27

Dual Antiplatelet Therapy vs Alteplase for Patients With Minor Nondisabling Acute Ischemic Stroke: The ARAMIS Randomized Clinical Trial.

Lancet (London, England), 2014-11-29

Effect of treatment delay, age, and stroke severity on the effects of intravenous thrombolysis with alteplase for acute ischaemic stroke: a meta-analysis of individual patient data from randomised trials.

Stroke, 1997 Nov

Generalized efficacy of t-PA for acute stroke. Subgroup analysis of the NINDS t-PA Stroke Trial.

The New England journal of medicine, 2023 Jan 04

Multiple Cerebral Hemorrhages in a Patient Receiving Lecanemab and Treated with t-PA for Stroke.

The journal of prevention of Alzheimer's disease, 2023

Lecanemab: Appropriate Use Recommendations.

Neurocritical care, 2005

Brain death-associated reflexes and automatisms.

Clinical neurophysiology practice, 2022 May 16

Spinal reflexes and brain death.

Radiology, 2016-06

Analysis of Workflow and Time to Treatment and the Effects on Outcome in Endovascular Treatment of Acute Ischemic Stroke: Results from the SWIFT PRIME Randomized Controlled Trial.

Neurologia medico-chirurgica, 2021 Dec 24

Randomized Clinical Trial of Endovascular Therapy for Acute Large Vessel Occlusion with Large Ischemic Core (RESCUE-Japan LIMIT): Rationale and Study Protocol.

The New England journal of medicine, 2023 Feb 10

Trial of Endovascular Thrombectomy for Large Ischemic Strokes.

The New England journal of medicine, 2023 Feb 10

Trial of Endovascular Therapy for Acute Ischemic Stroke with Large Infarct.

Journal of neuroimaging : official journal of the American Society of Neuroimaging, 2007-01

The Spencer's Curve: clinical implications of a classic hemodynamic model.

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2010

Intracranial atherosclerosis as a risk factor for ischemic stroke during open heart surgery.

Circulation, 2021 Apr 08

Perioperative Neurological Evaluation and Management to Lower the Risk of Acute Stroke in Patients Undergoing Noncardiac, Nonneurological Surgery: A Scientific Statement From the American Heart Association/American Stroke Association.

Journal of the American College of Cardiology, 2011 May 03

Stroke risk after coronary artery bypass graft surgery and extent of cerebral artery atherosclerosis.

JAMA, 2014 Jul 16

Time elapsed after ischemic stroke and risk of adverse cardiovascular events and mortality following elective noncardiac surgery.

JAMA surgery, 2022 Aug 10

Association of Time Elapsed Since Ischemic Stroke With Risk of Recurrent Stroke in Older Patients Undergoing Elective Nonneurologic, Noncardiac Surgery.

JAMA neurology, 2021 Mar 01

Clinical Presentation, Investigation Findings, and Treatment Outcomes of Spontaneous Intracranial Hypotension Syndrome: A Systematic Review and Meta-analysis.

JAMA neurology, 2022 Jan 01

Noncontrast Computed Tomography vs Computed Tomography Perfusion or Magnetic Resonance Imaging Selection in Late Presentation of Stroke With Large-Vessel Occlusion.

Lancet (London, England), 2023 Mar 29

Endovascular treatment versus no endovascular treatment after 6-24 h in patients with ischaemic stroke and collateral flow on CT angiography (MR CLEAN-LATE) in the Netherlands: a multicentre, open-label, blinded-endpoint, randomised, controlled, phase 3 trial.

Journal of neuroimaging : official journal of the American Society of Neuroimaging, 2020 Feb 10

Infarct Core Reliability by CT Perfusion is a Time-Dependent Phenomenon.

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2019 Oct 26

Computed Tomography Angiogram Derived From Computed Tomography Perfusion Done with Low Iodine Volume Protocol Preserves Diagnostic Yield for Middle Cerebral Artery-M2 Occlusions.

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association, 2022 Apr 14

CT Perfusion Maps Improve Detection of M2-MCA Occlusions in Acute Ischemic Stroke.

Lancet (London, England), 2014-01-25

Aggressive medical treatment with or without stenting in high-risk patients with intracranial artery stenosis (SAMMPRIS): the final results of a randomised trial.

Lancet Neurol, 2019 May 23

Cerebral microbleeds and stroke risk after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies.

The Lancet. Neurology, 2021 Mar 17

Development of imaging-based risk scores for prediction of intracranial haemorrhage and ischaemic stroke in patients taking antithrombotic therapy after ischaemic stroke or transient ischaemic attack: a pooled analysis of individual patient data from cohort studies.

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