Shashank Nagendra

Interventional Stroke Neurologist
@JJHospitalMumbai @DCNSNeuro

[JNIS @JNIS_BMJ]

Does automated CTP improve ASPECTS or collateral score reliability in late-window LVO stroke?

In this JNIS study, adding perfusion maps did not improve inter- or intra-rater reliability, nor correlation with EVT decisions.

NCCT + CTA alone remained reliable for EVT triage.

@AnassBenomarMD @DanniDiestro @RaceToTheBrain @vitorpereiracan @CarmenPFarinas @nishita_singh3 @CMHawkes @karlnarvacan @SmhNeuroVasc @UofTStroke @UofT

Read more: https://t.co/ZQgv3jI8l1

[Stephan A Mayer @stephanamayer]

Forty 40% of LVO pts with successful recanalization (TICI >2B) experience a spontaneous SBP drop (>40 mm Hg over <1 hr) over the next 24 hours.

These drops are associated with poor 90-day functional outcome and early neuro deterioration (22% bs 13%).

Unclear if the lower BP is driving the neuroworsening, or a biomarker of a fading pressor response due to adequate reperfusion.

https://t.co/yhgtGcviaf

[JAHA @JAHA_AHA]

Degree of narrowing is not the whole story. High-risk plaque features—intraluminal thrombi, webs, and dissections—are strongly linked to ipsilateral stroke in nonstenotic carotid disease. @Katha_MD @hankshas @AlmekhlafiMa @draravindganesh @nishita_singh3 https://t.co/Lbp2xXn0LZ

[Aravind Ganesh @draravindganesh]

🚨Nonstenotic carotid disease is often seen in stroke. In this @ActRrct paper led by @Katha_MD @nishita_singh3 we show that in such patients, intraluminal thrombi, webs, dissections &amp; rim sign are strongly assoc with ipsilateral stroke @JAHA_AHA @DCNSNeuro https://t.co/9WkVLy50Iq

[Shashank Nagendra @hankshas]

@SharathKumarGG7 @ManipalHealth Great case sir. How do you manage to get the 088 across the stenosed segment? Most of the time its difficult to even get the balloon across.

[Shashank Nagendra @hankshas]

@aditya_gan3500 @witchdrkochi @MicieliA_MD These patients were studied in the tempo 2 trial. Showed antiplatelets equivalent to TNK with demonstrable intracranial occlusion. Here the patient has Afib as well. So anticoagulation can be considered although we need more data.

[Shashank Nagendra @hankshas]

@SharathKumarGG7 Nice case. Which catheter do you recommend for venous manometry?

[Shashank Nagendra @hankshas]

@SharathKumarGG7 Great cases! Thanks for sharing. Any opinion on type of stent [ (CGuard) vs closed cell vs open cell] given the different pathophysiology at play?

[Shashank Nagendra @hankshas]

@ShadiYaghi2 Thank you!

[Shashank Nagendra @hankshas]

@Atirahcus @ihs_official @Simona_Sacco_ Fantastic @Atirahcus . Many congratulations!

[Shashank Nagendra @hankshas]

Please to share our experience with Tenecteplase at our centre #TNK #AIS

[Shashank Nagendra @hankshas]

@nishita_singh3 @JournalCJNS @amyyu_md @DrTejasSankar Congratulations!

[Shashank Nagendra @hankshas]

@SharathKumarGG7 @ApolloKarnataka Interesting case. Thanks for sharing. Does the pulsatile tinnitus resolve completely post procedure?

[Shashank Nagendra @hankshas]

@doctorboletoh Congratulations!

[Lea Alhilali, MD @teachplaygrub]

Time to give birth to a new idea!

Need a way to remember the neuro complications in pregnancy?

Try this baby step to help you remember the most common Neuro complications in pregnancy that we see on imaging!

Just remember the four “P”s of “P”regnancy!

They are..

▶️Palsy (Bell’s)
▶️PRES
▶️Plugged up venous sinuses
▶️Pituitary apoplexy

Of course, there are many other neuro complications in pregnancy, but these are the classic ones you always need to think about

Hopefully, now the four P’s will give birth to a new era for you when it comes to imaging pregnant patients!

[Shashank Nagendra @hankshas]

@Atirahcus @Shireen0701 @abgohel @FA_PGI @D_NEuRO All the best to the team!

[Shashank Nagendra @hankshas]

@drrhaul @DrSanjay277 Happy birthday!

[Shashank Nagendra @hankshas]

35 yr F presenting with a single focal seizure, no headache with CT showing focal edema in the right frontal cortex. DSA showing an isolated thrombosed vein of Trolard with intact Supr Sagittal sinus. What is the natural history and optimal duration of anticoaguln?

[Shashank Nagendra @hankshas]

A variation not seen very often. Prominent anterior meningeal artery in a non operated individual.