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Traversing Transverse Myelitis

We all place transverse myelitis on our broad differential of acute and dangerous causes of back pain in the emergency department. However, given the rarity of this condition and the rarity of when we make the diagnosis even when present, let's take a deeper look into this condition and determine what the emergency physician must know.

intern report

tPA

While working on the Neurocritical care service, I have enjoyed seeing the teamwork between neurologists and emergency medicine physicians. Neurologists rely on the EM physician to inform them of potential stroke patients in the ED, while EM physicians use the neurologist as a guide in treatment management; however, in my short time on the service, I have seen a vast array of opinions on the administration of tPA. Tissue plasminogen activator or alteplase is a fantastic drug that saves lives when used in the right patient population. That is where the controversy lies. What is the right patient population and how do we avoid wasting valuable resources on non-stroke patients?