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Vascular Neurology Notes @vascularnotes

Notes and Clinical Pearls gathered while reading articles and books covering Vascular Neurology, Neuroanatomy, and Neurointervention • Fellow run

Joined June 2020
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Vascular Neurology Notes@vascularnotes
13 Oct 2020
A great reference to keep close-at-hand by @JeremyHeitMDPHD
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Large vessel occlusion stroke patients should be taken for thrombectomy within 7 hours, even if imaging doesn’t look favorable…
Tudor G. Jovin, MD@TudorGJovin
18 Oct 2023
Honored to present LASTE results @slice_inr together with @CostalatV @CarolineArquiz1 @lapergue6. Strong benefit of thrombectomy within 7 hrs in unlimitedly large core.NNT 4.Equal benefit in ASPECTS 0-2 vs 3-5 & lower mortality. No more reasons to exclude pts based on imaging !!
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They are limited and are only used to assist in decision making but important to be familiar with them. Clinical Scales in Aneurysm Rupture Prediction | Stroke: Vascular and Interventional Neurology ahajournals.org/doi/full/10.…
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Workflow for patients with symptoms concerning for aSAH. ahajournals.org/doi/epdf/10.…
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13% of patients will die in the hospital of aneurysmal subarachnoid hemorrhage, and up to 26% will die before arriving at the hospital. If ≥2 first-degree relatives with cerebral aneurysms -> you have a 12% chance of having one ahajournals.org/doi/epdf/10.…
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Vascular Neurology Notes retweeted
Giana Dawod, MD@gdawod1
9 May 2023
1/ CTA. DSA. MRA. CFD. VWI. So many letters, so many ❓❓❓ & so the discussion ensues - which imaging are YOU going to use for intracranial aneurysm dx mgt?   Luckily, Beaman et. al go thru /- of imaging modalities - both old new🧠   Let's begin! 👇

ALT Season 2 Andy GIF by Parks and Recreation

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Interesting results comparing medical management to med thrombectomy for isolated PCA strokes. Notes: -Multicenter observational -Higher symptomatic ICH and END in thrombectomy patients -mRS not better for thrombectomy patients RCT may be warranted ahajournals.org/doi/10.1161/…
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One caveat is that mRS is unlikely to be a great assessment tool for isolated PCA infarcts. A trial should assess visual fields.
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Important arterial connections at the skull base. Be careful with embolizations of the middle meningeal artery that may cause facial paralysis or hearing loss. ahajournals.org/doi/full/10.…
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It appears that clots should be removed even when the core infarct is large, 2 new studies in NEJM: #thrombectomy for all nejm.org/doi/full/10.1056/NE… nejm.org/doi/full/10.1056/NE…

Trial of Endovascular Thrombectomy for Large Ischemic Strokes | NEJM

Trials of the efficacy and safety of endovascular thrombectomy in patients with large ischemic strokes have been carried out in limited populations. We performed a prospective, randomized, open-lab...

nejm.org
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Sturge-Weber Syndrome patients may present to the hospital with stroke like episodes that often fully resolve over a period of days, weeks, or months. MRI rarely shows diffusion restriction, but impaired venous drainage is common on perfusion imaging. pubmed.ncbi.nlm.nih.gov/3626…
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A new method for ischemic stroke treatment? “Molecularly self‐fueled nano-penetrator for nonpharmaceutical treatment of thrombosis and ischemic stroke” nature.com/articles/s41467-0…

Molecularly self‐fueled nano-penetrator for nonpharmaceutical treatment of thrombosis and ischemic...

Nature Communications - Thrombotic cerebro-cardiovascular diseases are the leading causes of disability and death worldwide but current drug therapeutics show important limitations. Here, the...

nature.com
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The thalamostriate vein does not drain the thalamus
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Thrombectomy beyond 24 hours from last known well? This study demonstrated worse outcomes overall (as one might expect), but similar hemorrhages/complications compared to the 6–24 hours group. Study by @ashabanmd et al. jnis.bmj.com/content/early/2…
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Are you at the SVIN conference in LA?! @svinsociety great opportunity to meet leaders/friends in the field
45% Yes
55% No
11 votes • Final results
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Which component of Wallenberg Syndrome is the most disabling? Tough disease for such a small infarct... Most occur with V4 segment occlusion, remainder with PICA occlusion or lateral medullary arteries.
2% Loss of taste
30% Ataxia
64% Dysphagia/Dysarthria
4% Numbness or Horners
94 votes • Final results
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The U.S. neuroendovascular workforce in 2013 and 2019, respectively, was as follows: radiologists (46% vs 44%), neurosurgeons (45% vs 35%), and neurologists (9% vs 21%). jnis.bmj.com/content/early/2…
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New CASSISS study from China compares medical management to medicine Wingspan stenting in patients with ICAD. ->No significant difference ->Relatively low stroke rates in both groups (see SAMMPRIS) ->Question remains:why do some patients still fail? jamanetwork.com/journals/jam…

Effect of Stenting Plus Medical Therapy vs Medical Therapy Alone on Risk of Stroke and Death in...

This randomized clinical trial compares the efficacy of percutaneous transluminal angioplasty and stenting plus medical therapy vs medical therapy alone in reducing the risk of stroke or death among...

jamanetwork.com
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Cinematic rendering reconstruction of intracranial arteries showing right paraclinoid aneurysm Read More: ajronline.org/doi/10.2214/AJ…
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The era of TNK begins! 0.25 mg/kg thelancet.com/journals/lance…
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“The M1 segment of the middle cerebral artery precedes by a few hundred million years the appearance of the M2 segment.” -Lasjaunias, Berenstein, and Ter Brugge
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