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EM Cases

EM Cases: ED Stroke Management in the Age of Endovascular Therapy

Which patients need what type of scanning? Where should that scanning be done – at the stroke center or at the peripheral center? Which patients should get systemic thrombolytics? Which patients should get endovascular therapy? In this EM Cases main episode podcast, a follow up to our episode on TIA released in November 2018 with Walter Himmel and David Dushenski, we try to simplify the confusing time-based and brain tissue-based options for stroke management…


EM@3AM: Spontaneous Intracerebral Hemorrhage

A 65-year-old male presents with altered mental status and right sided weakness. Symptoms began approximately two hours earlier when the patient began to complain of a severe headache. He has become more confused and is now unable to walk normally. Vital Signs: BP 202/98, HR 89, RR 12, T 36.7, SpO2 98% RA. Exam reveals an uncomfortable gentleman who is able to state his name, but unable to give the correct date or his location. He has profound right sided weakness in both upper and lower extremities. What's your next step?