Ep181 Cerebral Venous Thrombosis, Idiopathic Intracranial Hypertension, Giant Cell Arteritis and Peripartum Headaches

In this episode, Dr. Roy Baskind and Dr. Ahmit Shah answer such questions as: when is an opening pressure on LP required? When should we pull the trigger on ordering a CT venogram in the patient with unexplained headache? Which older patients who present with headache require an ESR/CRP? How do the presentations of cerebral venous thrombosis (CVT) and idiopathic intracranial hypertension (IIH) compare and contrast? When is it safe to start steroids in the ED for patients suspected of giant cell arteritis (GCA); will starting steroids affect the accuracy of a temporal artery biopsy? How soon should patients suspected of GCA get a temporal artery biopsy? When should we consider posterior reversible encephalopathy syndrome (PRES) and pituitary apoplexy in the peripartum patient? How should we think about the differential diagnosis of vascular headaches? and many more... 

Ep 161 Red Flag Headaches: General Approach and Cervical Artery Dissections

In this Part 1 or our two part podcast series on Red Flag Headaches we discuss a general approach, tips and tricks to assessing patients who present with headache followed by a deep dive into cervical artery dissections. With the help of Dr. Roy Baskind and Dr. Amit Shah we answers questions such as: what are the big 4 headache diagnoses that are not routinely picked up on plain CT or LP? Why are the symptoms of cervical artery dissection often fluctuating? Why do the symptoms of cervical artery dissection sometimes seem to not fit an anatomical distribution? What are the key clinical features that would trigger you to suspect cervical artery dissection? How do you decide which patients require a CT angiogram? What is the evidence for a causal relationship between chiropractic manipulation and cervical artery dissections?  What is evidence for antiplatelet agents, anticoagulants and thrombolysis in the management of cervical artery dissection? Which patients with cervical artery dissection can be safely discharged from the ED and many more...

Ep156 ED Approach to Acute Motor Weakness

In this Part 1 of our 2-part podcast on Acute Motor Weakness we introduce a five step approach to acute motor weakness with Dr. Roy Baskind Dr. George Porfiris: 1. Does the complaint of weakness represent a true loss of motor power? 2. The geography of weakness - patterns of motor power loss 3. Timing, course and fatigability of acute motor weakness 4. Distinguish upper versus lower motor neuron weakness by degree and speed of movement 5. Differentiate the types of lower motor neuron lesions - peripheral neuropathy vs neuromuscular junction vs myopathy, as well as review the indication for endotracheal intubation for the patient with neuromuscular weakness...

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