Neurology

Welcome back to the “52 in 52” series. This week we cover the EXTEND trial looking at thrombolysis up to 9 hours after stroke onset.

A 53-year-old female with a history of hypertension presents to the ED with headache and dizziness.  Her symptoms have been constant over the last two weeks. Triage vital signs (VS) include BP 163/89, HR 78, T 98.4, RR 14, SpO2 98% on room air. On exam, no nystagmus is noted. Her extraocular movements and cranial nerves II-XII are intact, strength of all four extremities is 5/5 without any focal weakness, and there are no appreciable sensory deficits. There is, however, dysmetria of the right upper extremity. What should you consider?

This post looks at the Neurocritical Care Society guideline updates for the management of aneurysmal subarachnoid hemorrhage, including blood pressure management, antifibrinolytics, calcium channel blockers, fluids, and more.

This week we cover “Thrombolysis with alteplase 3–4.5 hours after acute ischemic stroke: trial reanalysis adjusted for baseline imbalances”, a reanalysis of ECASIII and tPA for stroke.

52 in 52 looks at sensitivity of multi-slice CT for subarachnoid hemorrhage at different timepoints from symptom onset.

The emDOCs podcast returns with spinal epidural abscess.

When should you consider optic neuritis, and what is the evaluation and management?

How should you evaluate and manage the patient with spinal cord injury?

What are the current neurointerventional management techniques for large vessel occlusion ischemic stroke?