Neurology
Episode 17 Part 2: Stroke, Dabigatran and Intracranial Hemorrhage
In the 2nd part of this episode on Stroke, Dabigitran & Intracranial Hemorrhage Dr. Walter Himmel & Dr. Dan Selchen tell us everything the ED doc needs to know about the oral direct thrombin inhibitor Dabigatran and how to reverse a Dabigatran ICH. The ED treatment of stroke is reviewed including best medications and a simple way to remember BP goals. They review the management of ICH including BP goals, indications for neurosurgery, the role of recombinant Factor Vlla, and how best to reverse Warfarin-associated and platelet-associated ICH.
Episode 17 Part 1: Emergency Stroke Controversies
Ep17 P1 StrokeDr. Walter Himmel, "the walking encyclopedia of Emergency Medicine" & Dr. Dan Selchen, the head of the stroke program at St. Micheal's Hospital in Toronto with 30+ years of experience as a stroke neurologist, update us on the literature regarding Emergency Stroke Controversies including the ABCD2 Score to predict Stroke after TIA, as well as the current thinking around the best carotid imaging for patients who have had a TIA. They then review the important findings of the key thrombolysis stroke trials & how we could incorporate these findings into our daily practice. Dr. Selchen reviews the key CT findings we should look for in stroke, & Dr. Himmel takes us through how to manage the dreaded complication of ICH post thrombolysis. This episode is super controversial - so please 'speak your mind' at the bottom of the page.
Best Case Ever 3: Emergency Headache – Importance of Opening Pressure
In association with Episode 14, 'Headache Pearls & Pitfalls' with Dr. Anil Chopra and Dr. Stella Yiu, we present here, the third of our new 5 minute 'Best Case Ever' series. In Episode 14: Headache Pearls & Pitfalls, which has just been released, Dr. Chopra and Dr. Yiu answer questions like: With the ever improving resolution of CT, should we still be doing LP after negative plain CT head for all our thunderclap headache patients? How can we best minimize the chance of post-LP headache? What evidenced-based treatments can we initiate in the ED for our SAH patients that will improve outcomes? [wpfilebase tag=file id=375 tpl=emc-play /] [wpfilebase tag=file id=374 tpl=emc-mp3 /]
Episode 14 Part 2: Thunderclap Headache – Cerebral Venous Thrombosis and Cervical Artery Dissection
emergency headacheIn Part 2 of this episode on Thunderclap Headache - Cerebral Venous Thrombosis & Cervical Artery Dissction, Dr. Stella Yiu and Dr. Anil Chopra review the presentation, work-up and management of some of the less common but very serious causes of headache including Cervical Artery Dissection (CAD), Cerebral Venous Thrombosis (CVT) and Idopathic Intracranial Hypertension (IIH). They tell us the most effective ways in which we can minimize the chance of the common Post-LP Headache. They answer questions such as: How does a carotid artery dissection present compared to a vertebral artery dissection? What is the evidence for chiropractic neck manipulation as a cause for Cervical Artery Dissection? How do antiplatelets compare to heparin for the treatment of Cervical Artery Dissection? What is Spontaneous Intracranial Hypotension? What is the differential diagnosis for headache in the peri-partum patient? Does D-dimer have a role in ruling out Cerebral Venous Thrombosis in the low risk patient? What is the imaging modality of choice for suspected Cerebral Venous Thrombosis? What is the value of opening pressure when performing an LP? What are the key headache diagnoses that can be missed on plain CT of the head and would warrant further investigation? and many more.....
Episode 14 Part 1: Migraine Headache and Subarachnoid Hemorrhage
In Part 1 of this episode on Headache Pearls & Pitfalls - Migraine Headache & Subarachnoid Hemorrhage, Dr. Anil Chopra and Dr. Stella Yiu discuss the best evidenced-based management of migraine headache in the ED including the use of dexamethasone, dopamine antagonists, the problems with narcotics and the efficacy of 'triptans'. An easy way to remember the worrisome symptoms of headache indicating a serious cause is reviewed followed by a detailed discussion of the pearls, pitfalls and controversies around the work-up of Subarachnoid Hemorrhage (SAH) in light of some exciting recent literature, including the basis for a new Canadian decision rule for SAH.
Episode 13 Part 2: Killer Coma Cases – The Intoxicated Patient
In part 2 of this episode Dr. Helman presents two more cases to Dr. Carr and Dr. Steinhart, who give us their insights into the common conundrums when it comes to the intoxicated ED patient, and some key clues to the not-so-common life threatening toxicological emergencies that we need to be on the look out for.
