The Good, the Bad and the Ugly of the NIHSS: Time for a Change?

August 31, 2021
The NIHSS remains the fundamental assessment of stroke severity. However, some have called for modifying the NIHSS to better capture disability. Is it time to change the NIHSS?
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What Else Beyond the NIHSS Should We Be Doing Clinically?

August 24, 2021
The NIHSS was a research tool meant to limit variability and provide uniform quantifiable assessments  of stroke severity.  As the de facto standard for stroke exams and scores, it has withstood the test of time.  However, there is more to the assessment of acute stroke severity and this podcast takes a deep dive into what else we need to be doing besides the NIHSS.
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The Clock Is Dead - The Reign of Tissue Imaging

August 17, 2021
Mismatch is your friend if you want to treat acute stroke patients beyond 3 hrs. While the clock was once the king, tissue imaging may now define what brain is salvageable and what has been lost. Listen here and see if you agree that the clock is dead in stroke.
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Defining the SOC - Is 4.5 Hrs the Real Answer?

August 10, 2021
The standard of care can feel elusive. Listen here as Dr. Knight shares his expertise regarding the definition of the SOC in extended window therapy for tPA. It's not a simple question and Dr. Knight is the one to answer it.
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How Do I Identify Patients at Risk for a Secondary Event Following an Initial Acute Ischemic Stroke?

August 3, 2021
Identification of patients at high risk for secondary ischemic event, after initial event or post TIA...is minimal tissue damage really that big of a deal related to secondary stroke? Drs. Galen Henderson of Brigham and Women’s Hospital and Jordan Bonomo of the University of Cincinnati discuss key perspectives from a neurocritical, emergency medicine, and stroke perspective related to this important area of medicine.
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Nov 30

How do we implement ANNEXXa-I into our Clinical Practice?

Haemin Go posted on 11/30/2023


Moderator: W. Brian Gibler, MD, FACEP, FACC, FAHA
Other Participants: MD, Paul P. Dobesh, PharmD, FACC, FAHA, FCCP, BCPS, BCCP; Gregory J. Fermann, MD; Natalie Kreitzer, MD, MS

An anticoagulated patient presenting to the Emergency Department or Neurocritical Care Unit with intracranial hemorrhage (ICH) represents one of the most challenging clinical cases faced by emergency physicians and neurointensivists. Reversal of anticoagulation associated with treatment using Factor Xa inhibitors requires understanding the action of a specific agent, andexanet alfa. The ANNEXa-I trial, a randomized, controlled clinical trial for patients with ICH on anticoagulation, was stopped early before study completion in June 2024 due to efficacy of the andexanet alfa treatment arm versus usual care. In October 2023, a presentation at the 2023 World Stroke Conference provided further information on the trial results. In this Podcast, the faculty discusses the implications of ANNEXa-I for optimal management of ICH in the Emergency Department and Neurocritical Care Unit.


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