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Which antithrombotic therapy do you use for cervical artery dissection?

  • 0%Anticoagulation

  • 0%Antiplatelets

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.

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Severe headache, nausea, and vomiting!

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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:

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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


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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:


Nader Guma
29 févr. 2024

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.


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The patient was admitted to the intensive care unit.


What is your diagnosis?

  • Epidural hematoma

  • Subdural hematoma

  • Subarachnoid hematoma

  • Intracerebral hemorrhage


Mazen Kherallah
Mazen Kherallah
29 févr. 2024

@EveryoneThe fact that this patient had a lucid period and the appearance of the bleed with a convex/lens-shape hemorrhage indicates that this is more likely epidural hematoma as compared to concave/crescent shaped hemorrhage in subdural hematoma. Thank you @Nader Guma for your comment and images.

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

what’s your diagnosis

  • 0%intracerebral hemorrhage

  • 0%subarachnoid Hemorrhage

  • 0%cavernous sinus thrombosis

  • 0%epidural bleed


Hossam Aziz
28 févr. 2024

Answer is Subarachnoid Hemorrhage

- Ct angiogram shows an extensive subarachnoid hemorrhage (blood appearing as white hyper intense areas) with inter-ventricular extensions.

- Most common causes of a traumatic subarachnoid hemorrhage is saccular (berry) aneurysm rupture.


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