Internal Medicine

A meta-analysis of randomized trials comparing anticoagulation and antiplatelet therapy for cervical artery dissection found no significant difference in the composite outcome of ischemic stroke, death, or major bleeding at 90 days. Specifically, 3 out of 218 patients in the anticoagulation group and 10 out of 226 in the antiplatelet group experienced primary outcome events. Secondary analysis suggested fewer ischemic strokes but more major bleeding events with anticoagulation. Larger trials are needed to confirm these findings and explore newer treatments.

Severe headache, nausea, and vomiting!

Large area of ischemia involving the left frontotemporal region and right mesial frontal lobe without hemorrhagic transformation. Slightly increased edema and left to right midline shift. What would you recommend?

Large areas of cytotoxic edema involving the bilateral cerebral hemispheres and right cerebellum consistent with acute or subacute ischemia associated with sulcal effacement and edema without significant midline shift.

Compare this to her normal CT of head few days ago:

How Would You Prevent Subsequent Strokes in This Patient? Grand Rounds Discussion From Beth Israel Deaconess Medical Center.

Interesting discussion. To access, click on the link 👇🏽

https://doi.org/10.7326/M23-3136

Electroencephalography (EEG) reveals suppressed background with triphasic waves demonstrating diffuse cerebral disease after cardiac arrest.

Tips and tricks in management of cryptogenic stroke and PFO

1-This topic is considered of the controversial topics

2-To be able to select the appropriate patient who will benefit from PFO closure, we should go through 2 parallel tracks:

-Neurologist track

-Cardiologist track

I-Neurologist track:

56 years old patient with blunt trauma on the head who had decreased level of consciousness right after the injury but improved gradually to decline later within 24 hours and presented to ER where CT scan of the head was obtained.

The patient was admitted to the intensive care unit.

54 year old woman evaluated for unresponsiveness, Ct angiogram is shown