Validation and Refinement of Scores to Predict Very Early Stroke Risk after TIA
When encountering patients with TIA, how do you decide to admit or not admit? The reason for admission should include those patients at high risk for stroke. So how do you risk stratify TIA patients? The ABCD2 score is a…
Thrombolysis with Alteplase 3 to 4.5 Hours after Acute Ischemic Stroke (ECASS III)
Time is tissue—and the brain is no exception. Here's the landmark article guiding our use of thombolytics within 4.5 hours of an acute stroke. Remember, the clock starts ticking from the patient's last well-known time, not from the time of…
Dexamethasone in Adults with Bacterial Meningitis
The mainstay of treatment for bacterial meningitis are: High-dose IV antibiotics: Ceftriaxone, Vancomycin, +/- Ampicillin Steroids Patient isolation Here's the evidence for using steroids in bacterial meningitis.
Symptom-triggered versus Fixed-schedule Doses of Benzodiazepine for Alcohol Withdrawal
The Ativan Protocal at Olive View is a symptom-based algorithm for treatment of alcohol withdrawal. Here's the evidence for use of the symptom-based CIWA scale to determine the dosing of lorazepam as compared to fixed dosing of benzodiazepine. Read the…
Aspirin and clopidogrel compared with clopidogrel alone after recent CVA/TIA (MATCH Trial)
Antiplatelet therapy is the cornerstone of secondary prevention of Stroke and TIA. But in contrast to acute coronary syndrome where patients get one year of aspirin plus clopidogrel, is there evidence of benefit for combination therapy after stroke/TIA? This article…
High-dose Atorvastatin after Stroke or Transient Ischemic Attack
Here are some questions to think about as you review this study: What adverse events were associated with the use of atorvastatin? Are these results externally valid and applicable to your patients diagnosed with ischemic stroke or TIA? How was…
Strange Behavior in a Patient with HIV
What’s your differential diagnosis to explain the “strange behavior” of a patient with newly diagnosed HIV/AIDS?