Podcasts about intracranial

Intracranial meningiomas are the most common benign brain tumor that develop or arise from any meningeal surface of the brain, and are typically attached to the dura (outer layer of the meninges) but can also occur in the cerebral ventricles. Listen to Dr. Daniel Kelly, MD, PNI founder & director, and neurosurgeon, talk about intracranial meningioma symptoms, treatment and minimally invasive keyhole brain surgery. https://www.pacificneuroscienceinstitute.org/brain-tumor/conditions/meningioma/.https://www.pacificneuroscienceinstitute.org/brain-tumor/treatment/minimally-invasive-brain-surgery/https://www.pacificneuroscienceinstitute.org/brain-tumor/people/daniel-kelly/Pacific Brain Tumor CenterPh: 310-582-7450

Today, you'll learn about why our brains are getting bigger and why that's a good thing, how the sweet songs of the reef could help save it, and an AI device that gives a voice to the voiceless. Bigger Brains “Human brains are getting larger. That may be good news for dementia risk.” UC David Health. 2024. “Trends in Intracranial and Cerebral Volumes of Framingham Heart Study Participants Born 1930 to 1970.” by Charles DeCarli, MD, et al. 2024. “Framingham Heart Study.” Framingham Heart Study. N.d. “Study examines factors behind decline in dementia incidence.” NIH. 2016. Reef Songs “Sounds appealing - reef recordings entice coral larvae to start building.” by Ben Coxworth. 2024. “Life Below Water.” UN. n.d. “Status of Coral Reefs.” Reef Resilience Network. N.d. “Soundscape enrichment increases larval settlement rates for the brooding coral Porites astreoides.” by Nadege Aoki, et al. 2024. AI Speech “Speaking without vocal cords, thanks to a new AI-assisted wearable device.” by Christine Wei-li Lee. 2024. “Speaking without vocal folds using a machine-learning-assisted wearable sensing-actuation system.” by Ziyuan Che, et al. 2024. Follow Curiosity Daily on your favorite podcast app to get smarter with Calli and Nate — for free! Still curious? Get exclusive science shows, nature documentaries, and more real-life entertainment on discovery+! Go to https://discoveryplus.com/curiosity to start your 7-day free trial. discovery+ is currently only available for US subscribers. Hosted on Acast. See acast.com/privacy for more information.

The first multidisciplinary consensus guideline for the diagnosis and treatment of spontaneous intracranial hypotension (SIH) has recently been published by the UK SIH Specialist Interest Group. Group members Prof. Manjit Matharu (1), Dr. Indran Davagnanam (2), and Mr. Parag Sayal (3) join Dr. Amy Ross-Russell to explain their recommendations. They discuss the impact this condition has on patients, the possible presentations, and approaches for diagnosis and treatment.   Read the article: Spontaneous intracranial hypotension   (1) Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, London, UK (2) Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, London, UK (3) Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK

Women's brains are finally getting the research attention they deserve! While we sort out the role hormones play in our current and future cognitive health, it's important to remember that estrogen is just one player in a lifelong host of factors impacting your brain, including education, intellectual engagement, diet and nutrition, exercise and fitness, hearing loss, head injuries, sleep, stress levels, community, purpose, and much more! Hormones are part of the picture, but don't outweigh everything else. There are many actions we can take to improve cognitive function and brain health, whether or not we also use hormone therapy. We dive into it all this week with neuroscientist Dr. Sarah McKay.Dr. Sarah McKay is an Oxford University-educated neuroscientist and educator. She is the director of The Neuroscience Academy and author of The Women's Brain Book: The Neuroscience of Health, Hormones and Happiness. Dr. McKay teaches coaches, therapists, teachers and other professionals how to thoughtfully apply insights and tools from neuroscience to their work. You can learn more about her and buy her book at drsarahmckay.comResourcesMenopause impacts human brain structure, connectivity, energy metabolism, and amyloid‑beta deposition study here.Systematic review and meta-analysis of the effects of menopause hormone therapy on risk of Alzheimer's disease and dementia study here. Sex-specific associations of serum cortisol with brain biomarkers of Alzheimer's risk study here.Hormone Replacement Therapy Could Ward off Alzheimer's Among At-Risk Women research hereTrends in Intracranial and Cerebral Volumes of Framingham Heart Study Participants Born 1930 to 1970 study here. Register for the Feisty Summer STRONG Course: https://www.womensperformance.com/strong Subscribe to the Feisty 40+ newsletter: https://feistymedia.ac-page.com/feisty-40-sign-up-page Follow Us on Instagram:Feisty Menopause: @feistymenopause Feisty Media: @feisty_media Selene: @fitchick3 Hit Play Not Pause Facebook Group: https://www.facebook.com/groups/807943973376099 Join Level Up - Our Community for Active Women Navigating the Menopause Transition:Join: https://www.feistymenopause.com/monthly-membership-1 Leave your questions for Selene:https://www.speakpipe.com/hitplay Get the Free Feisty Women's Guide to Lifting Heavy Sh*t:https://www.feistymenopause.com/liftheavy Support our Partners:Previnex: Get 15% off your first order with code HITPLAY at https://www.previnex.com/ Lagoon Sleep: Go to LagoonSleep.com/hitplay and take the 2 minute sleep quiz to find your match, and then use the code HITPLAY for 15% off your first purchase

In this week's Master Class, Dr Stephan Mayer and Dr Jon Rosenberg are joined by Dr Krishna Rajajee to discuss non-invasive intracranial pressure monitoring

Contributor: Travis Barlock MD Educational Pearls: Thrombolytic therapy (tPA or TNK) is often used in the ED for strokes Use of anticoagulants with INR > 1.7 or  PT >15 Warfarin will reliably increase the INR Current use of Direct thrombin inhibitor or Factor Xa inhibitor  aPTT/PT/INR are insufficient to assess the degree of anticoagulant effect of Factor Xa inhibitors like apixaban (Eliquis) and rivaroxaban (Xarelto)  Intracranial or intraspinal surgery in the last 3 months Intracranial neoplasms or arteriovenous malformations also increase the risk of bleeding Current intracranial or subarachnoid hemorrhage History of intracranial hemorrhage from thrombolytic therapy also contraindicates tPA/TNK Recent (within 21 days) or active gastrointestinal bleed Hypertension BP >185 systolic or >110 diastolic Administer labetalol before thrombolytics to lower blood pressure Timing of symptoms Onset > 4.5 hours contraindicates tPA Platelet count < 100,000 BGL < 50 Potential alternative explanation for stroke-like symptoms obviating need for thrombolytics References 1. Fugate JE, Rabinstein AA. Absolute and Relative Contraindications to IV rt-PA for Acute Ischemic Stroke. The Neurohospitalist. 2015;5(3):110-121. doi:10.1177/1941874415578532 2. Powers WJ, Rabinstein AA, Ackerson T, et al. Guidelines for the Early Management of Patients with Acute Ischemic Stroke: 2019 Update to the 2018 Guidelines for the Early Management of Acute Ischemic Stroke a Guideline for Healthcare Professionals from the American Heart Association/American Stroke Association. Vol 50.; 2019. doi:10.1161/STR.0000000000000211 Summarized by Jorge Chalit, OMSII | Edited by Jorge Chalit

Headache medicine relies heavily on the patient's history, perhaps more than any other field in neurology. A systematic approach to history taking is critical in evaluating patients with headache. In this episode, Katie Grouse, MD, FAAN, speaks with Deborah Friedman, MD, MPH, FAAN author of the article “Approach to the Patient With Headache,” in the Continuum April 2024 Headache issue. Dr. Grouse is Dr. Grouse is a Continuum® Audio interviewer and a clinical assistant professor at the University of California San Francisco in San Francisco, California. Dr. Friedman is a neuro-Ophthalmologist and headache specialist in Dallas, Texas. Additional Resources Read the article: Approach to the Patient with Headache Subscribe to Continuum: continpub.com/Spring2024 Earn CME (available only to AAN members): continpub.com/AudioCME Continuum® Aloud (verbatim audio-book style recordings of articles available only to Continuum® subscribers): continpub.com/Aloud More about the American Academy of Neurology: aan.com Social Media facebook.com/continuumcme @ContinuumAAN Transcript Dr Jones: This is Dr Lyell Jones, Editor-in-Chief of Continuum, the premier topic-based neurology clinical review and CME journal from the American Academy of Neurology. Thank you for joining us on Continuum Audio, a companion podcast to the journal. Continuum Audio features conversations with the guest editors and authors of Continuum, who are the leading experts in their fields. Subscribers to the Continuum journal can read the full article or listen to verbatim recordings of the article by visiting the link in the Show Notes. Subscribers also have access to exclusive audio content not featured on the podcast. As an ad-free journal entirely supported by subscriptions, if you're not already a subscriber, we encourage you to become one. For more information on subscribing, please visit the link in the Show Notes. AAN members: Stay tuned after the episode to hear how you can get CME for listening. Dr Grouse: This is Dr. Katie Grouse. Today, I'm interviewing Dr Deborah Friedman on approach to the clinic patient with headache, which is part of an issue on headache. Dr. Friedman is a neuro-ophthalmologist and headache specialist in Dallas, Texas. Deborah, I'd love if we could just start by you telling us more about you. How did you become interested in the diagnosis and treatment of headache? Dr Friedman: I guess one of the lessons in life that I have learned regarding this question is, “never say never.” I started as a neuro-ophthalmologist - that's what I did my fellowship in. My very first job was in Syracuse, New York, at Upstate Medical University, and there was no headache specialist in Syracuse at the time. And I started seeing neuro-ophthalmology patients and specifically told the person who did my scheduling for me, “Do not schedule headache patients. I am not a headache doctor; I'm a neuro-ophthalmologist.” Well, these people just snuck in the door. They got referred in for their visual disturbances, right - we know what that was - or for their, you know, transient loss of vision or some type of visual manifestation of migraine or eye pain, right? So, I started seeing the patients and I figure, “Well, I did a neurology residency; I can treat headache as well as anybody else.” And so I started treating their headaches. and they would come back to see me in follow-up and say, “You gave me my life back,” and I was pretty blown away by that. This was a few decades ago, and we didn't give very many people “their lives back” at the time in neurology, so I decided I should go learn more about headache medicine. And I started attending national meetings of what is now the American Headache Society. I found that I really, really loved treating headache, and it has a natural marriage with neuro-ophthalmology. As my career progressed, I ended up doing more headache medicine and less neuro-ophthalmology, but I still love both. Dr Grouse: Yeah, absolutely. I think the treatment of headache can be so satisfying and I'm so happy to hear that you were able to discover that love of treating headache in your own career. Why do you think it's important for neurology clinicians to read your article? Dr Friedman: Well, headache is the most common disorder seen in general neurology. It is actually the most common neurological disorder overall, by a factor of ten. And it is one of the most common causes of neurologic disability worldwide - like it's in (routinely in) the top five. So, it's an important problem, and patients are going to come see us, and we need to know how to effectively interview them so we can effectively manage them. I think, in a nutshell, that's why. Dr Grouse: You mentioned in your article the importance of making time to discuss the headache - so much so that, actually, you said that if they mentioned it offhand at the end of the visit that they have a headache, you really should be scheduling time for them to come back, to prepare and organize the information, and to have the time to really talk with them. I find this is such an important point and, in my mind, really gets to the heart of what you're trying to tell us in your article - that the way you take the history can make or break your ability to diagnose and treat the problem. Can you talk more about that? Dr Friedman: Sure. The history is absolutely the most important part of the office visit with headache medicine. I mean, they always say, “In medicine and in neurology, ninety percent of the diagnosis is made by history.” And that is more than true in headache medicine. So, you have to really get a good history. And it's a skill, but there's also kind of an art to it. So, there are certain questions you want to have answers to, but there's also this art of how to relate to the patient and how to really get them to tell you what you need to know, right? When I wrote the article, I really tried to convey that, because I think a lot of it can be learned. But there are a lot of nuances to taking a headache history, and I think that, for many people, it's helpful to have a guide to do that. Dr Grouse: Following up on what you just said - you mentioned, of course, the art of taking the good history for headache, which I completely agree is absolutely true. However, in your article, you also mentioned that things like various questionnaire tools, AI, can also be really helpful for diagnosis, which seems to be the opposite of the art of medicine. Tell me more about how you can incorporate that into taking your history. Dr Friedman: I find that questionnaires are incredibly helpful. I devised my own - it is one of the questionnaires that's available in the article (there's a link for it). It's not that I just read the questionnaire and I walk in the room knowing exactly what's going on - sometimes that's true - but at least I have a good idea of what I'm going to be facing when I walk into the room and start talking to the patient. The other reason (perhaps more importantly) that I think it's so helpful is because it gets the patient thinking about the details of their headaches and the details of their life and, you know, like, what medications they've taken in the past. And it really prepares the patient for the interview. In a lot of ways, I think that's more important than the information it gives me. But I do look at all the questionnaires, and I'll say, “Well, you know, you checked off this, and what did you mean by that? And you said this or that on your questionnaire.” And I kind of refer to it so they at least know that I looked at it - there's nothing more irritating than filling out a long questionnaire and then nobody ever looks at it - so, I do look at it and I do acknowledge in front of them that I have looked at it and am looking at it. But I think that they help in many ways. There are programs in AI that the patient will just enter information into online and the program will just spit out a narrative, as well as a diagnosis or a differential diagnosis. For clinicians that are really under a lot of time constraints, I think these can help considerably as well. Dr Grouse: That's really interesting, and that actually brings me to the next question I wanted to ask, which was - do you have any tips for the many busy neurologists out there (many listening to this podcast right now) who really want to do a good job gathering information and taking a careful history but are really limited on time to be able to do this? What other tools out there would you recommend for them, or tips? Dr Friedman: Yeah, I think that probably the questionnaires and the AI-based programs are very helpful. There is - I have no financial relationship with this company; I just happen to know about it and I know the people that developed it - but it's called BonTriage (as opposed to bon voyage), and it was developed by headache specialists. And I've seen the product and I've seen the output that can be used, and I think that one is incredibly helpful. It was really made for primary care, so that people could do this thing online and then just walk in with a piece of paper, hand it to their primary care doctor, and they'd have the whole history and the differential diagnosis. But it's equally as useful for neurologists. Dr Grouse: How about in history taking - any tricks to get the history you need and let the patient feel heard without necessarily taking lots of time going down the wrong pathway? Dr Friedman: Yeah, that can be really hard, and sometimes patients just want to bring you down what you would consider the wrong pathway (obviously, they consider it the right pathway). People have different styles of interviewing and people have different styles of answering the question. I find that it's often very obvious early on whether the patient is going to do better by asking closed-ended questions or asking open-ended questions. I always start with open-ended questions because the research says that that's more helpful, and that getting the patient to describe their headache disability is one of the most important things that you can do, so you should ask it right up front. But some people - when you ask them the questions (as you probably know), they just go on and on and on, and it's really not the way that you might process information. So sometimes I just have to take it back and ask them very specific questions – “Do you have this symptom? Do you have that symptom? How long does this last? What triggers your headache?” - that kind of stuff. It's very, I think, specific to an individual patient. Dr Grouse: Yeah, that absolutely makes sense. Your article highlights some important and frequently missed causes of headache, including hemicrania continua and intracranial hypotension, and specifically, you have some example cases that you talk about. I have to say, reading those certainly triggers my own latent fear of misdiagnosis of these important causes of secondary headache. Can you highlight some of the important questions to ask or situations to keep in mind in order not to miss these? Dr Friedman: Sure. You know, those examples in the article came from my practice. I had to alter them a little bit because they're not supposed to sound like real people, but the patient with hemicrania continua was a real - I wouldn't say necessarily “eye opener” - but it really hit home with me. I spent all this time taking the history from the patient. She'd seen numerous doctors beforehand; they all thought she had chronic migraine. I take her history and I think she's got chronic migraine too, but she's trialed several medications; they haven't really worked, so, you know, we kind of ended it. I said, “Well, I think you have chronic migraine.” She came back for her follow-up visit and looked at me and said, “Could I have hemicrania continua?” At which point, I panicked. It's like, “Oh my god - I think I take a pretty good history, but what did I miss?” I'm like, looking through the note from the last visit and trying to figure out where I went wrong. And where I went wrong was, I never asked her, “Are you ever completely headache free?” And that is such an important question to ask because most often, when people come in and they start talking about their headaches, they talk about their worst headaches, right? Those are the ones that are really interfering with their lives. They often will just totally neglect to tell you that they have a headache almost every single day, but it's just mild and they don't pay attention to it. That was like a big lesson for me, and I try - it's even on my questionnaire – “Are you ever headache free?,” because it's just so important to know that. Intracranial hypotension is also one that you really have to be a detective for. A lot of times, the imaging will help us, but about ten, fifteen, twenty percent of people with intracranial hypotension have normal imaging. Then it becomes like this whole quest of making a diagnosis based on your clinical impression, right? So, there are just a lot of different things that you can ask and there are a lot of different symptoms people can have. One of the important lessons I learned in there was asking about orthostatic headache; the common way to ask that is, “Does it get better when you lie down?” Well, with few exceptions, most people with headache prefer to lie down, right? People with migraine prefer to lie down. But their headache doesn't get better just because they were lying down. It gets better because they took medicine and maybe they went to sleep. So, it's not just, “Is it better when you're lying down?” Is not going to sleep is part of it? And conversely, we want to know like what they feel like when they first wake up in the morning before they get out of bed, right? So just asking about, “Well, what's your headache like in the morning?” - that's not going to necessarily get the answer you want. So there are, again, kind of fine points about asking some of these questions to really find out what you need to know. Dr Grouse: Absolutely - that makes sense, that the intracranial hypotension case was another one that really, you know, makes me go back and think, “Gosh, how many of these might I have missed in my own career?” You know, such an easy-to-miss case based on what was described. Dr Friedman: I go through the same thing. I think that, early in my career, I could think back to patients that I probably missed that diagnosis. One of them I even sent to (may he rest in peace) Dr Mokri, who described it, and I sent him the imaging. He said, “No, this patient doesn't have it.” But knowing what we know now, I think she probably did. Dr Grouse: Wow. Transition to some other types of questions - what's the most common misconception you've encountered in treating patients with migraine? Dr Friedman: I would say that a lot of people think that migraine has to be (as the name implies) hemicranial. A substantial proportion of adults and even a higher proportion of children have migraine headaches that affect both sides of the head. I think that's really the most common misconception. Dr Grouse: What's the easiest mistake to make (and potentially avoid) when treating patients with migraine, or headache in general? Dr Friedman: Studies have been done looking at this question in migraine. The first mistake is not giving the patient a correct diagnosis. And it is surprising in real life how many people walk out of the doctor's office and nobody's ever told them, “You have migraine with aura,” or “You have chronic migraine,” right, and giving them a very specific diagnosis. Second most common mistake in treatment is not offering them an acute treatment. So, many people are using over-the-counter medications that are not very effective, or even prescription medications that are not very effective. We have a lot of good treatments out now, and basically every patient with migraine should be offered an acute treatment. We also know that preventive treatment is massively underutilized. Again, studies (mostly by Richard Lipton and his group) have interviewed patients and done population studies, and people who clearly meet contemporary guidelines for offering preventive treatment are never offered it. So, I guess those would be my top three. Dr Grouse: Going on the theme of patients maybe not being offered the optimal treatments, what's the greatest inequity or disparity you see in treating patients with headache disorders? Dr Friedman: The first thing that contributes to that is - there is a shortage of headache specialists. There's also a shortage of neurologists, so that's a problem. There are certain groups that are less likely to seek care for headache. If people don't seek care, it makes it harder for us to treat them. African American males, in particular; Hispanics. I think that some of this might be stigma; some of this just might be cultural - I'm not sure. Women are more likely to seek care for migraine than men are. But there are what they refer to as, like, “islands of health-care disparity” throughout our country, where there are just not enough physicians, or even advanced practice providers working with physicians, to be able to take care of all these people. So, it's estimated that there are well over forty million people with migraine alone in the United States (not to mention all the other kinds of headaches), and there are really not enough of us to go around, and there are very long waiting times to get in to see us. So, some people will end up using the emergency room to treat their headaches, which is totally suboptimal and not a good experience for the patient, either. So, I think there are a lot of aspects to disparities in migraine care, and there is a group in the American Headache Society that actively focuses on this issue and has written papers about it. But I think it's multifaceted and it's going to take a lot of effort on both the part of us, as clinicians, as well as patients, recognizing that there is good treatment out there and people shouldn't have to live with these kinds of disorders. Dr. Grouse: Absolutely. This has been such an interesting article. I just wanted to end with one last question, which is, what do you think is the most important clinical message of your article that you hope our listeners take away from this podcast? Dr Friedman: I was really happy to be asked to write this article for Continuum. And I'm glad it is the lead article in Continuum because I think that taking the headache history is by far and away the most important part of the headache medicine evaluation. When I was asked to write it, I was specifically requested to write it from the perspective of a clinician seeing adult patients. And I just want to let the audience know that I did not neglect the pediatric patients - that there is a different chapter in Continuum that addresses the specifics of taking a history and what's important to ask from pediatric patients. It was really a joy to write the article. I hope that people read it and learn from it and enjoy it. Dr Grouse: I really thoroughly enjoyed this article - it was so interesting. Even as someone who does a lot of headache diagnosis and treatment myself, I learned a lot. I think it's such a rich source of information and I hope everyone takes advantage of the opportunity to read it and learn a little bit more about headache treatment and diagnosis. Thanks so much for coming to talk with us today. Dr Friedman: Thank you so much for inviting me. It was a pleasure. Dr Grouse: Again, today I've been interviewing Dr. Deborah Friedman whose article on Approach to the Patient with Headache appears in the most recent issue of Continuum on Headache. Be sure to check out Continuum Audio episodes from this and other issues, and thank you to our listeners for joining today. Dr. Monteith: This is Dr Teshamae Monteith, Associate Editor of Continuum Audio. If you've enjoyed this episode, you'll love the journal, which is full of in-depth and clinically relevant information important for neurology practice. Right now, during our Spring Special, all subscriptions are 15% off. Go to Continpub.com/Spring2024, or use the link in the episode notes to learn more and take advantage of this great discount. This offer ends June 30, 2024. AAN members: go to the link in the episode notes and complete the evaluation to get CME. Thank you for listening to Continuum Audio.

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021. Originally released: October 25, 2018 Every time you order an MRI with contrast, you should think to yourself, "Why do I need contrast?" Then, "If I need contrast, what are the risks?" This week's show is all about the risks of routine neuroimaging. Produced by James E Siegler. Music by Little Glass Men, Loyalty Freak Music, and Kevin McLeod. Sound effects by Mike Koenig, Daniel Simion. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast. REFERENCES McDonald RJ, McDonald JS, Kallmes DF, et al. Intracranial gadolinium deposition after contrast-enhanced MR imaging. Radiology 2015;275(3):772-82. PMID 25742194Pullicino R, Radon M, Biswas S, Bhojak M, Das K. A review of the current evidence on gadolinium deposition in the brain. Clin Neuroradiol 2018;28(2):159-69. PMID 29523896Rogosnitzky M, Branch S. Gadolinium-based contrast agent toxicity: a review of known and proposed mechanisms. Biometals 2016;29(3):365-76. PMID 27053146 We believe that the principles expressed or implied in the podcast remain valid, but certain details may be superseded by evolving knowledge since the episode's original release date.

Radiology read to you! Frank reads our spontaneous intracranial hypotension article to neuroradiologist and CSF leak expert Lalani Carlton Jones. Workup and management of CSF leaks has evolved rapidly over recent years so this will be a much needed update for many listeners.  Radiopaedia's spontaneous intracranial hypotension article  ► https://radiopaedia.org/articles/spontaneous-intracranial-hypotension-2 Radiopaedia's CSF venous fistula article ► https://radiopaedia.org/articles/csf-venous-fistula Radiopaedia 2024 Virtual Conference ► https://radiopaedia.org/courses/radiopaedia-2024-virtual-conference Become a supporter ► https://radiopaedia.org/supporters Get an All-Access Pass ► https://radiopaedia.org/courses/all-access-course-pass Andrew's X ► https://twitter.com/drandrewdixon Frank's X ► https://twitter.com/frankgaillard Ideas and Feedback ► podcast@radiopaedia.org   The Reading Room is a radiology podcast intended primarily for radiologists, radiology registrars and residents. 

Episode 21 March 11, 2024 | Intracranial hypertension and fetal stem cells. Watch "Ukraine Fetal Stem Cell Pioneers" free: https://www.youtube.com/watch?v=eqgQwh7kZDM Subscribe: https://stemcellsmovie.com Email: eric@ericmerola.com

CME credits: 1.00 Valid until: 01-03-2025 Claim your CME credit at https://reachmd.com/programs/cme/intracranial-activity-of-ros1-tkis/18157/ This program aims to raise awareness of approved and emerging targeted therapies and practice guidelines for ROS1+ NSCLC. It is critical to create a greater understanding of the limitations existing agents have with acquired resistance mutations and intracranial penetration and the potential advantage new and emerging agents offer to resolve and evade these challenges.

CME credits: 1.50 Valid until: 27-02-2025 Claim your CME credit at https://reachmd.com/programs/cme/emerging-data-in-the-management-of-intracranial-hemorrhage-in-the-anticoagulated-patient/18128/ Join experts and explore an exciting new frontier of care for patients on direct oral anticoagulants who present with an intracranial hemorrhage. Three factors can be used to optimize treatment: emerging data on anticoagulation reversal, artificial intelligence utilization, and evidence-based ABC care bundling. Learn how these developments transform clinical practice, deepen institutional expertise, and ultimately improve patient outcomes.

CME credits: 1.50 Valid until: 27-02-2025 Claim your CME credit at https://reachmd.com/programs/cme/abc-ich-does-care-bundling-improve-outcomes-for-patients-with-intracranial-hemorrhage/18127/ Join experts and explore an exciting new frontier of care for patients on direct oral anticoagulants who present with an intracranial hemorrhage. Three factors can be used to optimize treatment: emerging data on anticoagulation reversal, artificial intelligence utilization, and evidence-based ABC care bundling. Learn how these developments transform clinical practice, deepen institutional expertise, and ultimately improve patient outcomes.

CME credits: 1.50 Valid until: 27-02-2025 Claim your CME credit at https://reachmd.com/programs/cme/providing-optimal-care-for-the-anticoagulated-patient-with-intracranial-hemorrhage-in-the-acute-care-setting-does-the-patient-need-reversal-repletion-or-surgery/18125/ Join experts and explore an exciting new frontier of care for patients on direct oral anticoagulants who present with an intracranial hemorrhage. Three factors can be used to optimize treatment: emerging data on anticoagulation reversal, artificial intelligence utilization, and evidence-based ABC care bundling. Learn how these developments transform clinical practice, deepen institutional expertise, and ultimately improve patient outcomes.

For this episode of “Ask the Expert: Research Edition,” "Increased Intracranial Pressure in Pediatric MOG Antibody Disease," Krissy Dilger of SRNA was joined by Dr. Cynthia Wang and Dr. Linda Nguyen. They discussed MOG antibody disease and the significance of MOG antibodies in diagnosis (00:00:02-00:03:36). Dr. Nguyen highlighted the background of the study and how this research focused on determining the impact of elevated intracranial pressure on patient outcomes (00:03:52-00:06:56). She reviewed the implications of the findings for patient management, emphasizing the importance of early recognition and intervention to mitigate disability (00:10:34-00:14:02). Dr. Wang and Dr. Nguyen anticipated future studies and stressed the collaborative effort required for better patient outcomes and the need for ongoing research in this field (00:17:16-00:20:30). Dr. Linda Nguyen completed her MD, PhD training at West Virgina University in 2017, and then pediatric neurology residency at University of California San Diego in 2022. Currently, she is a neuroimmunology fellow at University of Texas Southwestern. Dr. Cynthia Wang received her medical degree from University of Texas Southwestern Medical Center in Dallas, Texas and completed a pediatrics and pediatric neurology residency at Mott Children's Hospital, University of Michigan Health System in Ann Arbor, Michigan. Dr. Wang completed her James T. Lubin Fellowship under the mentorship of Dr. Benjamin Greenberg at The University of Texas Southwestern and Children's Health. Her research study was a prospective, longitudinal study on acute disseminated encephalomyelitis (ADEM) to identify the clinical characteristics, treatment methods, and follow-up interventions that are associated with better and worse patient-centered outcomes.

In this episode, Dr. Linda Bluestein interviews Dr. Ilene Ruhoy about causes of brain fog, as well as its relationship to various conditions such as mast cell activation syndrome, craniocervical instability, dysautonomia, and CSF leaks. She explains how these conditions contribute to cognitive dysfunction and the importance of identifying underlying causes. Dr. Ruhoy emphasizes the need for a comprehensive evaluation and individualized treatment approach for patients experiencing brain fog.  They delve into the role of nutrition in cognitive function, emphasizing the impact of food choices on inflammation. They highlight the importance of avoiding processed foods and sugar, increasing vegetable consumption, and improving lifestyle factors.  Dr. Ruhoy shares surprising findings on the MRI of mast cell activation syndrome (MCAS) patients. YOUR host, as always, is Dr. Linda Bluestein, the Hypermobility MD.TakeawaysBrain fog is characterized by cognitive difficulties such as slow thinking, difficulty learning and recalling information, and trouble focusing and paying attention.Conditions such as mast cell activation syndrome (MCAS), craniocervical instability (CCI), dysautonomia, Ehlers-Danlos Syndromes, and CSF leaks can contribute to cognitive dysfunction and brain fog.Intracranial hypertension (high pressure), hypotension (low pressure), and Tarlov cysts can also contribute to brain fog. Identifying the underlying causes of brain fog is crucial for developing an effective treatment plan.A comprehensive evaluation, including medical history, imaging studies, and laboratory tests, can help determine the contributing factors and guide treatment decisions. Applying knowledge gained from podcasts and research in clinical practice can help healthcare professionals provide better care to their patients.Making a meaningful difference in patients' lives is a rewarding aspect of being a healthcare professional.Nutrition plays a crucial role in cognitive function, and food choices can either be anti-inflammatory or pro-inflammatory.Avoiding processed foods and sugar, increasing vegetable consumption, and improving lifestyle factors can positively impact cognitive function.Chapters00:00 Introduction of Dr. Ilene Ruhoy01:57 Defining Brain Fog04:14 Risk Factors for Brain Fog09:42 Identifying Contributing Factors11:52 Cognitive Dysfunction and Mast Cell Activation Syndrome14:09 Cognitive Dysfunction and Craniocervical Instability18:18 Cognitive Dysfunction and CSF Leak22:59 Cognitive Dysfunction and Dysautonomia25:25 Cognitive Dysfunction and Upper Cervical Instability30:12 Cognitive Dysfunction and CSF Leak38:11 Applying Knowledge in Clinical Practice39:04 The Importance of Making a Meaningful Difference40:31 The Role of Nutrition in Cognitive Function42:38 The Impact of Food Choices on Inflammation43:44 Avoiding Processed Foods and Sugar44:38 The Role of Complex Carbohydrates and Dairy45:28 Increasing Vegetable Consumption46:44 Improving Lifestyle Factors47:09 Where to Find Dr. Ilene Ruhoy OnlineConnect with YOUR Bendy Specialist, Dr. Linda Bluestein, MD at https://www.hypermobilitymd.com/.   Thank YOU so much for tuning in. We hope you found this episode informative, inspiring, useful, validating, and enjoyable. Join us on the next episode for YOUR time to level up your knowledge about hypermobility disorders and the people who have them.Join YOUR Bendy Bodies community at https://www.bendybodiespodcast.com/.      YOUR bendy body is our highest priority!

In this episode, Dr. Linda Bluestein interviews Dr. Ilene Ruhoy about causes of brain fog, as well as its relationship to various conditions such as mast cell activation syndrome, craniocervical instability, dysautonomia, and CSF leaks. She explains how these conditions contribute to cognitive dysfunction and the importance of identifying underlying causes. Dr. Ruhoy emphasizes the need for a comprehensive evaluation and individualized treatment approach for patients experiencing brain fog.  They delve into the role of nutrition in cognitive function, emphasizing the impact of food choices on inflammation. They highlight the importance of avoiding processed foods and sugar, increasing vegetable consumption, and improving lifestyle factors.  Dr. Ruhoy shares surprising findings on the MRI of mast cell activation syndrome (MCAS) patients. YOUR host, as always, is Dr. Linda Bluestein, the Hypermobility MD.TakeawaysBrain fog is characterized by cognitive difficulties such as slow thinking, difficulty learning and recalling information, and trouble focusing and paying attention.Conditions such as mast cell activation syndrome (MCAS), craniocervical instability (CCI), dysautonomia, Ehlers-Danlos Syndromes, and CSF leaks can contribute to cognitive dysfunction and brain fog.Intracranial hypertension (high pressure), hypotension (low pressure), and Tarlov cysts can also contribute to brain fog. Identifying the underlying causes of brain fog is crucial for developing an effective treatment plan.A comprehensive evaluation, including medical history, imaging studies, and laboratory tests, can help determine the contributing factors and guide treatment decisions. Applying knowledge gained from podcasts and research in clinical practice can help healthcare professionals provide better care to their patients.Making a meaningful difference in patients' lives is a rewarding aspect of being a healthcare professional.Nutrition plays a crucial role in cognitive function, and food choices can either be anti-inflammatory or pro-inflammatory.Avoiding processed foods and sugar, increasing vegetable consumption, and improving lifestyle factors can positively impact cognitive function.Chapters00:00 Introduction of Dr. Ilene Ruhoy01:57 Defining Brain Fog04:14 Risk Factors for Brain Fog09:42 Identifying Contributing Factors11:52 Cognitive Dysfunction and Mast Cell Activation Syndrome14:09 Cognitive Dysfunction and Craniocervical Instability18:18 Cognitive Dysfunction and CSF Leak22:59 Cognitive Dysfunction and Dysautonomia25:25 Cognitive Dysfunction and Upper Cervical Instability30:12 Cognitive Dysfunction and CSF Leak38:11 Applying Knowledge in Clinical Practice39:04 The Importance of Making a Meaningful Difference40:31 The Role of Nutrition in Cognitive Function42:38 The Impact of Food Choices on Inflammation43:44 Avoiding Processed Foods and Sugar44:38 The Role of Complex Carbohydrates and Dairy45:28 Increasing Vegetable Consumption46:44 Improving Lifestyle Factors47:09 Where to Find Dr. Ilene Ruhoy OnlineConnect with YOUR Bendy Specialist, Dr. Linda Bluestein, MD at https://www.hypermobilitymd.com/.   Thank YOU so much for tuning in. We hope you found this episode informative, inspiring, useful, validating, and enjoyable. Join us on the next episode for YOUR time to level up your knowledge about hypermobility disorders and the people who have them.Join YOUR Bendy Bodies community at https://www.bendybodiespodcast.com/.      YOUR bendy body is our highest priority!

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February 2024 Journal Club Podcast Title: Global Outcomes for Microsurgical Clipping of Unruptured Intracranial Aneurysms: A Benchmark Analysis of 2245 Cases To read journal article: https://journals.lww.com/neurosurgery/fulltext/2024/02000/global_outcomes_for_microsurgical_clipping_of.17.aspx Corresponding Author: Lasse Dührsen First Author: Richard Drexler Guest faculty: Alejandro Spiotta Moderator: Brian Saway Co-chair: Rafael Vega

Live Nursing Review with Regina MSN, RN! Every Monday & Wednesday we are live. LIKE, FOLLOW, & SUB @ReMarNurse for more.     7 Day of NCLEX: https://ReMarNurse.com/7days   Quick Facts for NCLEX Next Gen Study Guide here - https://bit.ly/QF-NGN Study with Professor Regina MSN, RN every Monday as you prepare for NCLEX Next Gen.   ► Create Free V2 Account - http://www.ReMarNurse.com ► Get Quick Facts Next Gen - https://bit.ly/QF-NGN ► Subscribe Now - http://bit.ly/ReMar-Subscription ► GET THE PODCAST: https://remarnurse.podbean.com/ ► WATCH LESSONS: http://bit.ly/ReMarNCLEXLectures/ ► FOLLOW ReMar on Instagram: https://www.instagram.com/ReMarNurse/ ► LIKE ReMar on Facebook: https://www.facebook.com/ReMarReview/   ReMar Review features weekly NCLEX review questions and lectures from Regina M. Callion MSN, RN. ReMar is the #1 content-based NCLEX review and has helped thousands of repeat testers pass NCLEX with a 99.2% student success rate! ReMar focuses on 100% core nursing content and as a result, has the best review to help nursing students to pass boards - fast!

This episode covers intracranial haemorrhage.Written notes can be found at https://zerotofinals.com/medicine/neurology/intracranialbleeds/ or in the neurology section of the 2nd edition of the Zero to Finals medicine book.The audio in the episode was expertly edited by Harry Watchman.

A brain aneurysm is also called a cerebral aneurysm or an intracranial aneurysm and refers to the same diagnosis. Muscular-walled tubes blood vessels called arteries are part of our circulation system. These tubes are how blood is conveyed from the heart to the brain, carrying oxygen and nutrients to support the brain and its functions. A diagnosis of a brain aneurysm means that a bulging, weak area exists in the wall of one of the arteries that supplies blood to the brain.Sandra Narayanan, MD, FAHA, FANA, FSVIN, FAAN, is board-certified in neurology and vascular neurology by the American Board of Psychiatry and Neurology and CAST (Committee on Advanced Subspecialty Training)-certified in neuroendovascular surgery. She is a vascular neurologist and neurointerventional surgeon at Pacific Stroke & Neurovascular Center, Pacific Neuroscience Institute. She is director of the neurointerventional program and co-director of the stroke program at Providence Saint Joseph Medical Center in Burbank.

Doctor Philipp Karschnia (Ludwig-Maximilians-University of Munich, Munich, Germany) discusses the Response Assessment in Neuro Oncology consortium's recommendations on standardised tissue sampling and processing during resection of diffuse intracranial glioma.Read the full Policy Review:https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(23)00453-9/fulltext?dgcid=buzzsprout_icw_podcast_generic_lanoncContinue this conversation on social!Follow us today at...https://twitter.com/thelancet & https://Twitter.com/TheLancetOncolhttps://instagram.com/thelancetgrouphttps://facebook.com/thelancetmedicaljournalhttps://linkedIn.com/company/the-lancethttps://youtube.com/thelancettv

CME credits: 1.25 Valid until: 09-10-2024 Claim your CME credit at https://reachmd.com/programs/cme/case-presentation-management-of-a-patient-with-anti-factor-xa-associated-intracranial-hemorrhage-ich/16234/ This program focuses on the management of life-threatening bleeds from a range of specialties: Emergency Medicine, Neurocritical Care, Trauma, and Gastroenterology. A panel of international Emergency Medicine experts will provide perspectives on each of the associated areas of bleeding and relevant clinical cases.

CME credits: 1.25 Valid until: 09-10-2024 Claim your CME credit at https://reachmd.com/programs/cme/intracranial-hemorrhage-decreasing-time-to-treatment-to-improve-outcomes/16235/ This program focuses on the management of life-threatening bleeds from a range of specialties: Emergency Medicine, Neurocritical Care, Trauma, and Gastroenterology. A panel of international Emergency Medicine experts will provide perspectives on each of the associated areas of bleeding and relevant clinical cases.

Contributor: Travis Barlock MD Education Pearls: The Cushing Reflex is a physiologic response to elevated intracranial pressure (ICP) Cushing's Triad: widened pulse pressure (systolic hypertension), bradycardia, and irregular respirations Increased ICP results from systolic hypertension, which causes a parasympathetic reflex to drop heart rate, leading to Cushing's Triad.  The Cushing Reflex is a sign of herniation Treatment includes: Hypertonic saline is comparable to mannitol and preferable in patients with hypovolemia or hyponatremia Give 250-500mL of 3%NaCl 20% Mannitol - given at a dose of 0.5-1 g/kg Each additional dose of 0.1 g/kg reduces ICP by 1 mm Hg 23.4% hypertonic saline is more often given in the neuro ICU 8.4% Sodium bicarbonate lowers ICP for 6 hours without causing metabolic acidosis Non-pharmacological interventions: Raise the head of the bed to 30-45 degrees Remove the c-collar to improve blood flow to the head Hyperventilation induces hypocapnia, which will vasoconsrict the cerebral arterioles You hyperventilate on the way to the OR. Otherwise, maintain normocapnia. References Alnemari AM, Krafcik BM, Mansour TR, Gaudin D. A Comparison of Pharmacologic Therapeutic Agents Used for the Reduction of Intracranial Pressure After Traumatic Brain Injury. World Neurosurg. 2017;106:509-528. doi:10.1016/j.wneu.2017.07.009 Bourdeaux C, Brown J. Sodium bicarbonate lowers intracranial pressure after traumatic brain injury. Neurocrit Care. 2010;13(1):24-28. doi:10.1007/s12028-010-9368-8 Dinallo S, Waseem M. Cushing Reflex. [Updated 2023 Mar 20]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK549801/ Godoy DA, Seifi A, Garza D, Lubillo-Montenegro S, Murillo-Cabezas F. Hyperventilation therapy for control of posttraumatic intracranial hypertension. Front Neurol. 2017;8(JUL):1-13. doi:10.3389/fneur.2017.00250 Summarized by Jorge Chalit, OMSII | Edited by Meg Joyce & Jorge Chalit, OMSII  

Listen to the sixth episode of NCS' INSIGHTS series, this time on Increased Intracranial Pressure. The INSIGHTS series is hosted by Casey Albin, MD and Salia Farrokh, PharmD, and covers different topics from Neurocritical Care ON CALL®, the only up-to-date, comprehensive resource to offer content exclusively dedicated to the practice of neurocritical care. Learn more about ON CALL®. This episode is sponsored by Biogen. Science that transforms patient lives. Science that seeks to solve societal problems. Science that acts with purpose. Science that is inspired by the diversity and passion of our people. Discover where science meets humanity at Biogen. The NCS Podcast is the official podcast of the Neurocritical Care Society.

Neurology Today Editor-in-chief Joseph E. Safdieh, MD, FAAN, discusses research that assesses the safety of endovascular treatment post-stroke for people with intracranial tumors, the AANEM guideline on IVIG use for neuromuscular disorders, and the latest data on donanemab.

Dr. Tesha Monteith talks with Dr. Wouter Schievink about what spontaneous intracranial hypotension is and why it's commonly misdiagnosed. Full podcast: https://directory.libsyn.com/episode/index/id/27833880

Dr. Tesha Monteith talks with Dr. Wouter Schievink about what spontaneous intracranial hypotension is and why it's commonly misdiagnosed.  Visit NPUb.org/Podcast for additional podcasts and associated article links.

Commentary by Dr Atsushi Nohara

CME credits: 1.50 Valid until: 31-03-2024 Claim your CME credit at https://reachmd.com/programs/cme/comparing-in-hospital-mortality-with-andexanet-alfa-versus-4-factor-prothrombin-complex-concentrate/14862/ Patients presenting to the hospital with severe bleeding and underlying treatment with Factor Xa (FXa) or Factor IIa inhibitors represent an enormous challenge to providers and clinicians since the approvals of apixaban, edoxaban, rivaroxaban, and dabigatran within the United States. Intracranial bleeding, intra-abdominal or thoracic trauma, gastrointestinal bleeding, and bleeding from any non-compressible source represent true life-threatening emergencies. Treatment of severe bleeding in patients receiving Factor Xa and Factor IIa inhibitors currently involves using non-specific therapy such as blood factor replacement - packed red blood cells (pRBCs), fresh frozen plasma, and platelets. With the development and approval of reversal agents, treatment of severe bleeding can now be specifically directed at the source of the coagulopathy combined with appropriate blood factor replacement. Nationally recognized guidelines have provided clear direction on how best to manage these types of major bleeding events. While published guidelines are an important resource in helping direct how to appropriately intervene, the inherent clinical and system challenge is as follows: How do I justify and juxtapose the clinical rationale for using a reversal agent with the inherent cost associated with it with a lack of comparative head-to-head studies? Our assessment of learners suggests that knowledge and …

Commentary by Dr. Candice Silversides

CME credits: 1.50 Valid until: 31-03-2024 Claim your CME credit at https://reachmd.com/programs/cme/andexanet-alfa-is-associated-with-lower-in-hospital-mortality-compared-to-4-factor-prothrombin-complex-concentrate-in-patients-with-factor-xa-inhibitorrelated-major-bleeding/14863/ Patients presenting to the hospital with severe bleeding and underlying treatment with Factor Xa (FXa) or Factor IIa inhibitors represent an enormous challenge to providers and clinicians since the approvals of apixaban, edoxaban, rivaroxaban, and dabigatran within the United States. Intracranial bleeding, intra-abdominal or thoracic trauma, gastrointestinal bleeding, and bleeding from any non-compressible source represent true life-threatening emergencies. Treatment of severe bleeding in patients receiving Factor Xa and Factor IIa inhibitors currently involves using non-specific therapy such as blood factor replacement - packed red blood cells (pRBCs), fresh frozen plasma, and platelets. With the development and approval of reversal agents, treatment of severe bleeding can now be specifically directed at the source of the coagulopathy combined with appropriate blood factor replacement. Nationally recognized guidelines have provided clear direction on how best to manage these types of major bleeding events. While published guidelines are an important resource in helping direct how to appropriately intervene, the inherent clinical and system challenge is as follows: How do I justify and juxtapose the clinical rationale for using a reversal agent with the inherent cost associated with it with a lack of comparative head-to-head studies? Our assessment of learners suggests that knowledge and …

CME credits: 1.50 Valid until: 31-03-2024 Claim your CME credit at https://reachmd.com/programs/cme/life-threatening-bleeding-in-the-anticoagulated-patient-real-world-evidence/14864/ Patients presenting to the hospital with severe bleeding and underlying treatment with Factor Xa (FXa) or Factor IIa inhibitors represent an enormous challenge to providers and clinicians since the approvals of apixaban, edoxaban, rivaroxaban, and dabigatran within the United States. Intracranial bleeding, intra-abdominal or thoracic trauma, gastrointestinal bleeding, and bleeding from any non-compressible source represent true life-threatening emergencies. Treatment of severe bleeding in patients receiving Factor Xa and Factor IIa inhibitors currently involves using non-specific therapy such as blood factor replacement - packed red blood cells (pRBCs), fresh frozen plasma, and platelets. With the development and approval of reversal agents, treatment of severe bleeding can now be specifically directed at the source of the coagulopathy combined with appropriate blood factor replacement. Nationally recognized guidelines have provided clear direction on how best to manage these types of major bleeding events. While published guidelines are an important resource in helping direct how to appropriately intervene, the inherent clinical and system challenge is as follows: How do I justify and juxtapose the clinical rationale for using a reversal agent with the inherent cost associated with it with a lack of comparative head-to-head studies? Our assessment of learners suggests that knowledge and …

Real World studies can provide the foundational support necessary for clinicians to effectively manage anticoagulated patients with severe, often life-threatening intracranial and gastrointestinal bleeding. While randomized controlled clinical trials have provided the initial data necessary for appropriate use of reversal agents such as andexanet alfa for Factor Xa associated bleeding, broader studies enrolling thousands of patients, many with significant co-morbidities, are extremely valuable to clinicians. New information regarding the randomized controlled trial ANEXXA-I, which was halted due to andexanet alfa efficacy, provides additional information supporting reversal therapy for severe bleeding.

CME credits: 1.50 Valid until: 20-06-2024 Claim your CME credit at https://reachmd.com/programs/cme/case-presentation-management-of-a-patient-with-vitamin-k-antagonist-associated-intracranial-hemorrhage-ich/15634/ This enduring activity was originally presented as a satellite symposium which was held during the 9th European Stroke Organisation Conference (ESOC) in Munich, Germany, in May 2023. As the utilization of direct oral anticoagulants (DOACs) increases, there is a parallel increase in major bleeding events, especially intracranial hemorrhages (ICH), requiring hospitalization. Clinicians are not recognizing or distinguishing major from minor bleeding or appropriately employing emergent options to manage major bleeding. Recent solutions for DOAC-related life-threatening bleeding are under-recognized and under-utilized solutions for patients with these life-threatening emergencies. Recently, nationally recognized guidelines have provided clear direction for managing these major bleeding events. As data emerges regarding new approaches to therapy, clinicians need to be aware of these new and effective approaches and assess the benefits and risks associated with each of these approaches. This program focuses on managing ICHs, addresses patient treatment approaches, and distills essential information for everyday clinical practice.

Dr. Andrew Callen discusses his paper, "Relationship of Bern Score, Spinal Elastance, and Opening Pressure in Patients With Spontaneous Intracranial Hypotension". Show reference: https://n.neurology.org/content/100/22/e2237 This podcast is sponsored by argenx. Visit www.vyvgarthcp.com for more information.

Dr. Derek Stitt talks with Dr. Andrew Callen about the relationship between bern score, spinal elastance, and opening pressure in patients with spontaneous intracranial hypotension. Read the related article in Neurology. For links to articles and previous podcast episodes, please visit NPUb.org/Podcast. This podcast is sponsored by argenx. Visit www.vyvgarthcp.com for more information.

This week on the BackTable ENT podcast, Dr. Gopi Shah and Dr. Amanda Stapleton, a pediatric otolaryngologist from UPMC Children's Hospital of Pittsburgh, chat about the unique challenges of treating pediatric sinus and skull base diseases, orbital complications, and biofilm-covered Moraxella. They discuss source control, biofilm, and her research focused on the bacteriology of pediatric chronic sinusitis and patients with cystic fibrosis. --- SHOW NOTES First, they discuss how to recognize the signs and symptoms of pediatric patients who present with orbital or intracranial abscesses and how age and location of the abscess can influence treatment decisions. They also explain how to distinguish between intracranial and orbital abscesses and how to recognize the symptoms of sphenoid sinusitis. Both doctors emphasize the importance of involving infectious disease colleagues to evaluate antibiotic coverage and surgical indications. Next, the doctors discuss the techniques for sinus surgery, including the use of a scope for visualization, warm irrigations, navigation, and augmented reality systems in the acute setting. Dr. Stapleton also provides tips on when to remove a middle turbinate and the importance of source control, especially in patients under the age of seven. An adenoidectomy may be necessary if the patient has had multiple colds throughout the winter and the decision is made to take down the lamina to drain an abscess pocket. Finally, the doctors discuss the follow up process for children with chronic sinusitis, which may include office endoscopy and allergy testing, and discuss the rare cases of intracranial abscesses. In addition to being vigilant and proactive in monitoring the potential for repeat infections, imaging to detect any scarring or residual mucosal inflammation that might have resulted from the initial infection is also helpful.

A 27-year-old, otherwise well, woman complains of recurrent headache that occurs every 1‒2 weeks and lasts up to 24 hours. During headache, she reports sudden onset of unilateral pulsating pain, nearly always on the left side that is accompanied by photophobia, phonophobia and mild nausea without vomiting. Her first headache occurred when she was approximately 12-years-old.  Her neurological exam is within normal limits. What is this clinical scenario most consistent with?A. Cluster headache B. Tension-type headache C. Intracranial lesion D. Migraine without aura---YouTube: https://www.youtube.com/watch?v=ZukohMkD4IA&list=PLf0PFEPBXfq592b5zCthlxSNIEM-H-EtD&index=16Visit fhea.com to learn more!

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Support this podcast at — https://redcircle.com/hypnosis-and-relaxation-sound-therapy9715/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

Support this podcast at — https://redcircle.com/hypnosis-and-relaxation-sound-therapy9715/donationsAdvertising Inquiries: https://redcircle.com/brandsPrivacy & Opt-Out: https://redcircle.com/privacy

MedLink Neurology Podcast is delighted to feature selected episodes from BrainWaves, courtesy of James E Siegler MD, its originator and host. BrainWaves is an academic audio podcast whose mission is to educate medical providers through clinical cases and topical reviews in neurology, medicine, and the humanities, and episodes originally aired from 2016 to 2021.Originally released: July 9, 2020Webster defines “idiopathic” as “arising spontaneously or from an obscure or unknown cause.” By definition, this means idiopathic intracranial hypertension has no proximate cause. But that's not exactly true. This week on the podcast, we explore the evidence behind the theory that transverse sinus stenosis may contribute to this condition. Disclaimer: No chicken or eggs were harmed in the making of this episode.Produced by James E Siegler. Music courtesy of Squire Tuck, Swelling, Three Chain Links, and Unheard Music Concepts. The opening theme was composed by Jimothy Dalton. Sound effects by Mike Koenig and Daniel Simion. Unless otherwise mentioned in the podcast, no competing financial interests exist in the content of this episode. BrainWaves' podcasts and online content are intended for medical education only and should not be used for clinical decision-making. Be sure to follow us on Twitter @brainwavesaudio for the latest updates to the podcast.REFERENCESDinkin MJ, Patsalides A. Venous sinus stenting in idiopathic intracranial hypertension: results of a prospective trial. J Neuroophthalmol 2017;37(2):113-21. PMID 27556959Farb RI, Vanek I, Scott JN, et al. Idiopathic intracranial hypertension: the prevalence and morphology of sinovenous stenosis. Neurology 2003;60(9):1418-24. PMID 12743224Gjerris F, Soelberg Sørensen P, Vorstrup S, Paulson OB. Intracranial pressure, conductance to cerebrospinal fluid outflow, and cerebral blood flow in patients with benign intracranial hypertension (pseudotumor cerebri). Ann Neurol 1985;17(2):158-62. PMID 3872097Karahalios DG, Rekate HL, Khayata MH, Apostolides PJ. Elevated intracranial venous pressure as a universal mechanism in pseudotumor cerebri of varying etiologies. Neurology 1996;46(1):198-202. PMID 8559374King JO, Mitchell PJ, Thomson KR, Tress BM. Manometry combined with cervical puncture in idiopathic intracranial hypertension. Neurology 2002;58(1):26-30. PMID 11781401Martins AN. Resistance to drainage of cerebrospinal fluid: clinical measurement and significance. J Neurol Neurosurg Psychiatry 1973;36(2):313-8. PMID 4541080Mohammaden MH, Husain MR, Brunozzi D, et al. Role of resistivity index analysis in the prediction of hemodynamically significant venous sinus stenosis in patient with idiopathic intracranial hypertension. Neurosurgery 2020;86(5):631-6. PMID 31384935Orefice G, Celentano L, Scaglione M, Davoli M, Striano S. Radioisotopic cisternography in benign intracranial hypertension of young obese women. A seven-case study and pathogenetic suggestions. Acta Neurol (Napoli) 1992;14(1):39-50. PMID 1580203Riggeal BD, Bruce BB, Saindane AM, et al. Clinical course of idiopathic intracranial hypertension with transverse sinus stenosis. Neurology 2013;80(3):289-95. PMID 23269597Rohr A, Dörner L, Stingele R, Buhl R, Alfke K, Jansen O. Reversibility of venous sinus obstruction in idiopathic intracranial hypertension. AJNR Am J Neuroradiol 2007;28(4):656

Dr. Katharina Wolf discusses her paper, "CSF Flow and Spinal Cord Motion in Patients With Spontaneous Intracranial Hypotension: A Phase Contrast MRI Study". Show references: https://n.neurology.org/content/early/2022/11/10/WNL.0000000000201527

Andrew Russman, DO, discusses the management and treatment of moyamoya disease in patients with large artery intracranial occlusive disease.

Dr. Scott Mintzer talks with Dr. Adithya Sivaraju about predicting outcomes among patients undergoing intracranial EEG. Read the full article in Neurology. This podcast is sponsored by argenx. Visit www.vyvgarthcp.com for more information.

Show notes at pharmacyjoe.com/episode731. In this episode, I'll discuss a company-sponsored indirect comparative study looking at andexanet alfa vs 4 factor prothrombin complex concentrate (4FPCC) for the reversal of apixaban- or rivaroxaban-associated intracranial hemorrhage. The post 731: Company sponsored indrect comparison concludes the company’s product is better for the reversal of apixaban- or rivaroxaban-associated intracranial hemorrhage appeared first on Pharmacy Joe.

Show notes at pharmacyjoe.com/episode731. In this episode, I ll discuss a company-sponsored indirect comparative study looking at andexanet alfa vs 4 factor prothrombin complex concentrate (4FPCC) for the reversal of apixaban- or rivaroxaban-associated intracranial hemorrhage. The post 731: Company sponsored indrect comparison concludes the company’s product is better for the reversal of apixaban- or rivaroxaban-associated intracranial hemorrhage appeared first on Pharmacy Joe.