Myasthenic Crisis

Myasthenia Gravis: Disease Overview Who: Bimodal distribution. Ages 20-40 (female predominance) and 50-70 (male predominance). Increased risk of onset in postpartum period; juvenile and congenital forms possible What: At the NMJ, Ach recept…

“Doc, I’m Blind!”

Super cool case, admittedly, maybe not a super high yield diagnosis BUT, I hope we can all agree, still very dope. Case: CC: 46yo M p/w worsening b/l vision over 1mo, now blind.  Vitals: WNL PMHx: L eye global rupture ~6mos ago 2/2 nail pen…

A can’t miss head CT finding

For today’s TR pearl, I’d like to take you back to January 2020, when covid was just a foreign virus and I was a fresh-faced intern, shadowing one of our recent grads, Dr. Sengupta in the cardiac room, along with Dr. Meyers. EMS…

SAH and CT

I wanted to touch on some cool research that was circulated in the SinaiEM Journal Club WhatsApp this morning inspired by the Journal Feed newsletter. If you have trouble staying up to date on EM research, Journal Feed can help! It sends on…

Cervical Artery Dissection

Cervical artery dissection (CAD) accounts for 1-2% of all ischemic strokes but 10-25% of strokes in younger individuals.  CAD includes extracranial carotid and vertebral artery dissections.  A review of the literature suggests that there ma…

TPA For Minor Stroke?

  So, you’re working in the ED when a new stroke code is activated. You walk over and see a young gentleman with the complaint of left facial tingling, right arm and leg weakness with some tingling. Overall though, a relatively w…

The Neuroprotective Intubation

Bottom line up front: (1) Intubating those with TBI or spontaneous ICH is dangerous. You want to prevent increased ICP that is caused by laryngoscopy. (2) Pre-treat with fentanyl if time and the pt’s BP allow. The dose of fentanyl is larger…

DAWN of a new era in stroke care

Thrombectomy performed within 6 hours of symptom onset has been demonstrated to significantly improve clinical outcomes after stroke. Though there is generally diminishing benefit with increased time interval from last known well to the tim…

The 52 in 52 review: Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke

Article Citation                                                                                                                             Hacke W, Kaste M, Bluhmki E, Brozman M, et al; ECASS Investigators. Thrombolysis with alteplase 3 t…

May 2022
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