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
High #Risk features in Nonstenotic #Carotid Plaque
🌒Beyond degree of #stenosis!
☝️You can use MRI, CTA, ultrasound, PET to evaluate
Intraplaque #hemorrhage, Thickness, Volume, Neovascularisation, Lipid core, #Ulceration, Thrombus, Calcifications, #Inflammation and +
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References:
Vulnerable Carotid Plaques
🔗https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(19)30035-3/abstract
High Risk carotid plaque Histopathology
🔗https://www.sciencedirect.com/science/article/abs/pii/S0895796717300091?via%3Dihub
PET in NS carotid plaques
🔗https://www.sciencedirect.com/science/article/abs/pii/S1071358123003835?via%3Dihub
Reclassification based on high-risk NS carotid plaques.
🔗https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.027970
#MondayTip
🧠In cardioembolic stroke we must look for the best moment to start anticoagulation combining the #lower risk of hemorrhagic #transformation and ischemic #recurrence ⚖️
👉Individualized strategy to start anticoagulation post EVT
(created from https://doi.org/10.5853/jos.2023.01578)
#Mondaytip
Pathophysiology of #pregnancy-related #stroke :
🌊Hemodynamic changes
🔗Vascular & connective tissue changes
🩸Changes in coagulation system
From: https://doi.org/10.1016/j.ncl.2018.09.010
#MondayTip
#Acute neurologic #worsening after AIS
🩸Spontaneous or rTPA/TNK-related bleed?
🛌BP dependent exam? flatten HoB, bolus IV, +/- pressors
🛑Reperfusion injury or reocclusion after EVT?
🪜Stuttering lacunar?
⚡️Non convulsive/post ictal state?
@caseyalbin Survival Guide
#MondayTip
👉Recurrent stroke after #PFO closure
Risk factors (univariate analysis):
⚖️Obesity
📈RoPE <7
🤕Migraine
🔗https://doi.org/10.1016/j.jstrokecerebrovasdis.2023.107448
#MondayTip
🧐The role of #MRI in diagnostic workup of #ESUS
☝️6.1% to 82.3% of patients w/ESUS were #reclassified using of MRI techniques like #cardiac MRI, MRA and/or #vesselwall MRI (vs standard workup) depending on the combination of imaging modalities
https://journals.sagepub.com/doi/10.1177/17474930231189946
#MondayTip
Small Vessel Disease & the #Glymphatic System
#cSVD and glymphatic dysfunction are anatomically connected and significant RF's are shared between the two:
🗜️Hypertension
🍬Diabetes
👴Advance age
🛌Poor sleep
🩺Obesity
🧠Neuroinflammation
🆓
🔗https://www.strokejournal.org/article/S1052-3057(24)00003-X/fulltext
#MondayTip
Hypothesis underlying #FactorXIa inhibitors efficacy & safety
👉Uncoupling #Hemostasis/#Thrombosis
Normal: clotting but thrombosis risk
F Xa i: ⬇️ thrombosis but can 🛑TF pathway 👉⬇️clotting
F XIa i: ⬇️ thrombosis w/o interfere in TF
From @Ash_Shoamanesh #WSC23
#Mondaytip
3rd Stroke #Recovery & #Rehabilitation Roundtable
#SRRR3
🌐 Global initiative w/ >50 experts, >20 countries
Focus:
👩🏾🤝👩🏽Control comparator trial design
😮💨Fatigue
🔉Non-invasive 🧠stimulation
🤸🏻Standardized measurement of balance & mobility
🆓
https://journals.sagepub.com/doi/full/10.1177/17474930231218329
#MondayTip
Hypothesis underlying #FactorXIa inhibitors efficacy & safety
👉Uncoupling #Hemostasis/#Thrombosis
Normal: clotting but thrombosis risk
F Xa i: ⬇️ thrombosis but can 🛑TF pathway 👉⬇️clotting
F XIa i: ⬇️ thrombosis w/o interfere in TF
From @Ash_Shoamanesh #WSC23
#MondayTip
🧠Proposed #algorithm for the management of Cerebral Venous Thrombosis
💡Just released #Guidelines offer essential insights for diagnosis and management of #CVT
🙌Great work by @gsaposnik @CBushnellMD & all the writing group
@StrokeAHA_ASA⤵️
https://www.ahajournals.org/doi/abs/10.1161/STR.0000000000000456
#MondayTip
🧠Proposed #algorithm for the management of Cerebral Venous Thrombosis
💡Just released #Guidelines offer essential insights for diagnosis and management of #CVT
🙌Great work by @gsaposnik @CBushnellMD & all the writing group
@StrokeAHA_ASA⤵️
https://www.ahajournals.org/doi/abs/10.1161/STR.0000000000000456
#MondayTip
Prepping for the upcoming #vasculitis webinar!
Vessel wall MRI concepts:
🌘Know vwMRI dogma & pitfalls
🔪Use it to select biopsy site
⭕️Concentric enhancement ≠ vasculitis
💡Multifocal narrowing👉think ICAD or RCVS
From Dr Danny Mandell #WSC23 http://tinyurl.com/2xbrz8dr
#MondayTip
As our "1ry Angiitis of CNS" webinar is coming, it's an excellent moment to make a #tbt to this illustrative teaching case by Moussaddy et al., and its great schematic summary of distinctive histopathologic changes in #CAA, #iCAA, #ABRA, #PACNS
https://www.ahajournals.org/doi/10.1161/STROKEAHA.115.010024
#MondayTip
☝️Myocardial injury is related to AIS even without prior cardiac disease, also called the #stroke_heart syndrome
🧠Acute lesions of the central autonomic network, especially the right hemispheric insula, are associated with an impaired LVEF🫀
https://svn.bmj.com/content/8/4/301
#MondayTip
☝️When you find a🫀right➡️left shunt on TTE/TCD in your <60 patient w/ cryptogenic ischemic stroke👉check for high-risk #PFO features:
🫧number of bubbles
🕳️aneurysmal interatrial septum
👂eustachian valve
🕸️Chiari network
#PASCAL
#RoPE
🔗https://www.ahajournals.org/doi/10.1161/STROKEAHA.123.040546
Don’t miss the webinar organized by the @WorldStrokeEd🧠 focusing on #stroke and #IA with our @TRUSTroke_EU Project coordinator @carlosmictusvh as a distinguished speaker🎙️ #webinaralert
