Michael Phipps, MD, MHS

Vascular Neurology Fellowship Director @umarylandneuro. Quality in healthcare, stroke, informatics. Advocate:patients, Neurology. Father, Husband. Views my own.

[Maria Shriver @mariashriver]

I’ve been thinking a lot about the extraordinary outbursts of the President of the United States against female journalists... well, actually against journalists in general and journalism. But it feels like he saves his most childlike behavior and irrational language for female reporters, calling them all kinds of names that kids in kindergarten are given times out for. It’s stunning to me to witness such behavior from any leader, any CEO, any person of influence or importance. I’ve never witnessed someone like this raging, this weekend with @meetthepress host @kwelkernbc, just last week in the Oval Office with @cnn’s @kaitlancollins, calling women stupid or piggy, telling them to “smile”, calling them darling, demeaning their credibility. Every good man should denounce this behavior. Every person should be able to stand up for their colleagues and say “No more.”

Imagine this man screaming like this at your daughter, your wife, your sister, your mother... would you stand for it? No, you wouldn’t! And neither should any of us. It’s unacceptable and undignified. Period. End of story.

[Seemant Chaturvedi @ChaturvediNeuro]

CASES trial shows no definite benefit with immediate CAS for patients with carotid occlusion or severe stenosis compared to deferred treatment. Improved vessel patency with early CAS. An interesting, mixed result! #ESOC2026

[Seemant Chaturvedi @ChaturvediNeuro]

HOPE trial reports improved outcome with post EVT SBP management tailored to reperfusion status. Needs to be reconciled with earlier negative trial results with BP lowering following EVT #ESOC2026 ⁦@svinsociety⁩

[Stephan A Mayer @stephanamayer]

I think that the jury has come down.

Big drops in BP after thrombectomy are associated with neuroworsening, AKI and poor outcome. Many of these drops are iatrogenic. Nicardipine is a great med, but you have to know how to use it well.

Beware those aggressive very low BP targets there’s some people think are beneficial because that’s what they were taught and trained to do.

As an intensivist, you should look at the ED and ANGIO suite pressures. When a patient rolls in extremely hypertensive 200+ pre-thrombectomy, if the instruction is to hammer the SBP down to 140, you can fight back. The evidence is there that SBP drops in the 60 to 80 range are harmful.

I like to step-by-step approach where you take the SBP down 40, then 60, then take it from there.

How do you deal with this issue?

[Pope Leo XIV @Pontifex]

Those who pray are aware of their own limitations; they do not kill or threaten with death. Instead, death enslaves those who have turned their backs on the living God, turning themselves and their own power into a mute, blind and deaf idol (Ps 115:4–8), to which they sacrifice every value, demanding that the whole world bend its knee. Enough of the idolatry of self and money! Enough of the display of power! Enough of war! True strength is shown in serving life. #Peace

[Seemant Chaturvedi @ChaturvediNeuro]

An absolute pleasure to host Drs Caplan and Albers for the 7th Caplan lecture at U Maryland Dept of Neurology! We now understand all the late window reperfusion options ⁦@WorldStrokeOrg⁩ ⁦@umarylandneuro⁩ ⁦@PracMeh⁩ ⁦@msphippsmd⁩

[H.Alvin Chen, MD MHSc @HAlvinChenNeuro]

For chronic subdural hematoma patients, standalone MMA embolization is associated with lower rates of new-onset dementia.

Check out our new paper in Stroke:

https://t.co/rLmBq7xFub

@marcocolasurdo @PeterKa80460001 @Dheeraj_NIS @dhairyalakhani @UMDNeurosurgery @umarylandneuro

[AHA Science @AHAScience]

Presented at #ISC26, the LAIS trial showed that when administered within 48 hours of AIS, loberamisal was associated with a 13% absolute increase in the proportion of adults achieving excellent functional outcomes at 90 days, with a favorable safety profile, compared to placebo.

Here is @Braindoc_MGH's take on the data.

[Alexander Vorobyev, MD @AlexVorobyevMD]

🚨 #ISC26 delivered BIG for stroke care. Multiple practice-important and promising trials across thrombosis, reperfusion, EVT, ICH, and neuroprotection 🏥🧠👇

🔹 OCEANIC-STROKE – Positive phase III: FXIa inhibition with asundexian reduced ischemic stroke in patients with non-cardioembolic stroke or high-risk TIA on antiplatelet therapy without increased major bleeding

🔹 OPTION – In patients with salvageable tissue, tenecteplase (4.5–24h) significantly improved 90-day excellent outcomes with higher sICH (2.8% vs 0%)

🔹 CHOICE-2 – Largest phase III trial of IA alteplase after successful EVT: higher excellent outcomes (mRS 0–1), no increase in sICH, NNT ≈ 7

🔹 FASTEST – rFVIIa for spontaneous ICH: promising early results in spot sign–positive patients treated <90 min

🔹 LAIS – Loberamisal (dual-target neuroprotection) within 48h for AIS (NIHSS 7–20): 13% absolute increase in excellent functional outcomes at 90 days

🔹 DISTALS – Tigertriever for distal occlusions: higher successful reperfusion at 24h without increased sICH

🔹 ORIENTA-MeVO – EVT for MeVO improved 90-day functional outcomes without excess sICH in a Chinese population

The stroke playbook is evolving in real time. 🔥
#Stroke #ISC26 #VascularNeurology #EVT #Tenecteplase #ICH #ClinicalTrials #AHAScience #StrokeResearch @StrokeAHA_ASA @AHAScience 🧠

[Seemant Chaturvedi @ChaturvediNeuro]

A great honor to receive the Sherman award at #ISC26. Many thanks to colleagues, mentors, and trainees over the years. ⁦@AHAScience⁩ ⁦@ESOstroke⁩ ⁦@WorldStrokeOrg⁩ ⁦@UMmedschool⁩ ⁦@umarylandneuro⁩ ⁦@umms⁩

[Ed Krassenstein @EdKrassen]

Wow, it’s finally happening! Republicans are waking up to the con that Donald Trump is.

Listen to this Trump voter who called into C-SPAN to apologize to the American people for voting for Trump.

He tears Trump apart for his racist meme about the Obama’s, as well as his inhumane ICE raids and his corruption.

[Johanna Seiden, MD MPH @JohannaSeidenMD]

MeVO Trials 2.0 @neurona_critica
#ISC26 @StrokeAHA_ASA
@caseyalbin @SposatoL @rkchoi @JimmySuhMD @JayDoliaMD @SitaraKoneru @gdawod1 @JenHarrisMD
@bustinclots247 @ShadiYaghi2 @AlexandraCzap
@a_charidimou @JimSiegler @svinsociety @BraydonDymm @Braindoc_MGH @rwregen @NguyenThanhMD

[Fawaz Al-Mufti, MD, FSVIN @almuftifawaz]

Despite my bias toward hyperacute stroke care, this is a big deal for the entire stroke field.

OCEANIC-STROKE mic drop at #ISC26.

Asundexian (Factor XIa inhibition) on top of SAPT/DAPT lowers recurrent stroke and major CV events without the hemorrhage tax.

The real impact won’t be in elite stroke centers.
It’ll be in fragile systems where bleeding is catastrophic.

The evidence is here. The only question is how fast we disseminate it globally and whether we let it stay siloed.

Sounds like a job for #MissionThrombectomy 🧠🌍
@BayerPharma #ISC26 @AHAScience @svinsociety #SVIN26

[Dr. Lee Schwamm @Braindoc_MGH]

Stroke Council Award recipient @PoojaKhatriMD breaking down silos in her great talk. No one knows better than Pooja and StrokeNet investigators that Stroke is a Team Sport! From bench to bedside to community living and back!

[Philosophy Of Physics @PhilosophyOfPhy]

Carl Sagan Called it in 1995...

[Seemant Chaturvedi @ChaturvediNeuro]

No overall benefit seen in FASTEST. However, those with positive spot sign had benefit in subgroup analysis. Very interesting ⁦@AHAScience⁩ #ISC26

[Dr. Lee Schwamm @Braindoc_MGH]

FASTEST trial F rVIIa for pts age 18-80, small volume of ICH and IVH and use of MSUs. Overall no change in outcomes with Rx but strong evidence of biological effect with &lt;hematoma growth. Spot Sign and treatment &lt;90 mins promising. Watch for phase 2 results! #ISC26 @AHAScience

[Seemant Chaturvedi @ChaturvediNeuro]

Remarkable results at #ISC26. Better outcomes with post-EVT thrombolysis seen in multi center trial ⁦@AHAScience⁩

[Lester Y. Leung, MD, MSc @LesterLeung]

The #Stroke and Young Adults (#SAYA) U.S. Consortium is a core group of stroke clinician-investigators, researchers, and #youngstroke survivor &amp; caregiver advocates from 13 CSCs. We’re meeting on Wednesday for our 4th annual mtg at #ISC26. Let me know if you want to join in!

[Dr. Lee Schwamm @Braindoc_MGH]

Massive and so well deserved recognition for the leadership, wisdom and guidance provided by Dr. Walter Koroshetz as a decade as Director of NINDS here at #ISC26 @AHAScience. Mentor to many, friend to all interested in neuroscience, and one of my personal heroes.