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EM@3AM: Brainstem Strokes

EMDocs

Answer : Brainstem stroke specifically in the pons resulting in locked in syndrome. CT head without contrast 1 is performed and reveals the following: Question: What is the diagnosis?

Stroke 88
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Tasty Morsels of Critical Care 008 | Decompressive Craniectomy for Stroke

Emergency Medicine Ireland

Just to be clear up front we’re going to be talking about taking the lid off for stroke, NOT taking the lid off for TBI. Just to be clear up front we’re going to be talking about taking the lid off for stroke, NOT taking the lid off for TBI. I will get to TBI. I will get to TBI but they are really quite different topics.

Stroke 40
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Blood Pressure Management in Neurologic Emergencies: What Does the Evidence Say?

EMDocs

This article will discuss blood pressure goals and preferred pharmacotherapy for non-traumatic ischemic and hemorrhagic strokes. Ischemic Strokes: Ischemic stroke is characterized by a blockage of a blood vessel in the brain. The BP targets for patients with ischemic strokes depend on the available therapeutic options.

Stroke 72
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EM@3AM: Basilar Artery Occlusion

EMDocs

Answer : Basilar Artery Occlusion Epidemiology:  Basilar artery occlusion (BAO) is a subset of the posterior circulation strokes. Posterior circulation strokes are estimated to account for 20% of all strokes, with BAO accounting for ~1% of all strokes. Symptoms may range from days to months prior to stroke onset.

EMS 73
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Glasgow Coma Scale in Children

Pediatric EM Morsels

Motor Fingernail bed pressure with a pencil first If flexion outcome, then apply painful stimulus to neck or head (trapezius or supraorbital notch) to look for localization Spinal reflex can result in a falsely elevated score if lower extremity pain induced Verbal Orientated- Able to answer all questions. A practical scale. PMID: 4136544.

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Rapid Blood Pressure Lowering in Patients with Acute Intracerebral Hemorrhage

All Ohio EM

By Mike Pallaci, DO Research Question: Does rapid lowering of blood pressure improve the outcome in patients with intracerebral hemorrhage? The primary outcome was determined for 2794 of these; 45 patients (1.6%) lost to follow-up. How Many Patients: The investigators enrolled 2839 patients.

Stroke 40
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Putting Clinical Gestalt to Work in the Emergency Department

ACEP Now

4 However, emergency physicians rely on gestalt to predict outcomes well. The externally validated Canadian Syncope Risk Score (CSRS) demonstrated no better prediction of 30-day adverse outcomes for “very low” and “low” risk patients than clinical judgment alone of emergency physicians. Mary’s Hospital in Leonardtown, Maryland.