World Stroke Organization #MondayTips
Every Monday, WSA Social Media Leader Rodrigo Guerrero publishes a #MondayTip on the WSA WorldStrokeEd Twitter account, covering a specific stroke related topic. You can find a compilation of our #MondayTips here!
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#MondayTip
Key studies on #DOAC vs VKA in CVT
🧠Several observational studies and small but important RCTs have evaluated the efficacy and safety of DOACs as an alternative to VKAs in Cerebral Venous Thrombosis
✅Results support DOACs as a reasonable treatment option
#MondayTip
#MeVO
After #ISC2025, what’s next for stroke management in medium vessel occlusion?
🤔 DISTAL, ESCAPE-MeVO & DISCOUNT showed no EVT benefit over BMT
Will this change your practice?
@FishingNeurons @mayank_G0 @TudorGJovin
#MondayTip
☝️#NoReflow has multiple mechs: https://bit.ly/41fbru7
💉#CHOICE trial showed better outc targeting microcirc w/IA rTPA
☝️Also, #Pericytes regulate capillary size in both physiological/pathological states
🎯Could they be a therapeutic target?
https://doi.org/10.1093/cvr/cvae147
#MondayTip
☝️Vertebrobasilar perforating arteries 🧠
⭕️These small but vital arteries are essential for supplying the #brainstem and critical areas of the #posterior circulation
From @eytanraz et al via @JNIS_BMJ
🆓
https://jnis.bmj.com/content/early/2024/11/01/jnis-2024-022144
#Mondaytip
⏲️#Timeisbrain🧠
☝️Even in hemorrhagic stroke!
Data from the #INTERACT studies highlights that earlier BP lowering significantly reduces relative hematoma growth
🫵Act fast for better outcomes!
💻Check more about #ICH here: https://bit.ly/4fzLGJ7
Still #Mondaytip somewhere 😅
#Large Core #Thrombectomy Trials:
Basic criteria (ASPECTS, time window)
Most used imaging
Primary outcome
Are you going to change your protocols regarding this group of patients?
#MondayTip
☝️We have learned that #ESUS is not just about atrial fibrillation
Some potential causes of #stroke in patient with ESUS
💡and when to suspect 🧐
From @SposatoL et al. review @GreenJournal
https://doi.org/10.1212/WNL.0000000000209535
#Mondaytip
From @Ash_Shoamanesh presentation in WSO/WSA #ICH Educational Program:
☝️Consider atypical (i.e., non-hypertensive) etiologies, especially if markers of #cSVD are absent on initial neuroimaging
🧠Keep this and other #clues in mind when evaluating patients with ICH
#MondayTip
Early neurological #deterioration in acute #lacunar stroke
📊15-20% of lacunar stroke
🕜Most common in the first 24-48hr
😥Associated with poor functional outcome
☝️Factors associated with END
From: https://doi.org/10.1177/17474930241273685
#MondayTip
#Lacunar ischaemic stroke is a combination of
🟢clinical findings suggestive of AIS
🟢due to a small subcortical ischaemic lesion
🟢thought to be due to cerebral small arterial disease #cSVD
https://doi.org/10.1177/23969873231219416
Clues to non cSVD etiologies in suspected lacunar AIS
#MondayTip
The #BrushSign in #CVT
Hypointensity of the subependymal & deep medullary veins in 🧠MRI
👉In CVT is associated with higher thrombus load
☝️This sign may be a marker of CVT severity and should prompt close monitoring during the acute phase
https://doi.org/10.1161/strokeaha.119.025342
#MondayTip
#Stroke in Bacterial #Meningitis
Cerebrovascular complications are #common in patients with bacterial meningitis and are associated with #unfavorable outcome and #death
🟢Cerebral infarction~9-25%
🔵CVT~1-10%
🔴ICH~1-7%
🟤SAH~1-5%
From https://doi.org/10.1161/SVIN.123.001435
🆓
#MondayTip
Lateral Medullary Region Arterial Supply
💡The lateral medulla is supplied by 5-6 small arterial branches
☝️Most lateral medullary infarcts result from vertebral artery compromise rather than PICA involvement
From CM Fisher, Kernes, and Kubik:
https://doi.org/10.1097/00005072-196107000-00001
#MondayTip
Ok, this is not actually a "tip", but we couldn't help but highlight the recent Leading Opinion paper by Bruce Campbell @TheRMH , on :
The current treatment and future direction of #hyperacute stroke care
#TNK #LVO
#openacces via @IntJStroke
https://journals.sagepub.com/doi/full/10.1177/17474930241267353
#MondayTip
#Cancer-associated stroke
🌎1 in 10 patients w/stroke also have comorbid cancer
☝️Cancer can also directly cause stroke
Mechanisms
🔸Tumor-induced hypercoagulability
🔸Direct invasion/compression of arteries
🔸Infection
🔸2ry effects of RT/CT
🔗https://doi.org/10.5853/jos.2023.03279
#MondayTip
☝️Cervical artery #dissection contributes to 2% of all ischemic strokes but up to 25% of ischemic stroke in adults <50 years of age
💎Predictors of ischemic stroke after #CAD
From: https://doi.org/10.1161/STR.0000000000000457
#OpenAccess
Dear colleagues and friends, our February newsletter is here with our latest educational activities on #Stroke:🆕e-Learning module, webinars, Paper of The Month and interviews!
👉Get your copy here: https://www.world-stroke-academy.org/news/february-newsletter-2/
