Saketh Annam, MBBS

PGY3 Neurology Resident @UMNNeuroRes | Vascular Neurology Research Fellow & Collaborator @umnstrokencc | 🇮🇳🇺🇸 #MedEd #NeuroTwitter #StrokeTwitter

[Lea Alhilali, MD @teachplaygrub]

1/Time is brain! But what time is it?

If you don’t know the time of stroke onset, are you able to deduce it from imaging?

Here’s a thread to help you date a stroke on MRI!

[NEJM @NEJM]

In the ENRICH trial of minimally invasive cerebral hematoma removal within 24 hours after onset of hemorrhage, functional outcomes were better with surgery than with medical treatment, particularly among patients with lobar hemorrhages. Full trial results: https://t.co/hXSRKwvdNk

[Andreas Charidimou MD, PhD @a_charidimou]

🦓🩸🧠Rare causes of Intracerebral Hemorrhage (ICH) and how to find them

~Clinical context, age, parenchymal & vascular imaging
🛑 Pointers/clues for rare causes👇👇

🤯Thunderclap headache: RCVS, CVT, aSAH
🌡️Fever: CNS infection, endocarditis, systemic angiitis
🦀Active cancer: mets, clotting abnormalities
🧠Ischemic+hemorrhagic lesions: CVT, RCVS, PRES, endocarditis, CNS vasculitis
🫧Disproportionate edema: mets, CVT, PRES
#⃣Multiple ICHs: Mets, CVT, RCVS, vasculitis, endocarditis
🪱Leptomeningeal enhancement: meningitis, vasculitis
🩸Associated SAH: Aneurysm, CVT, RCVS, DAVF, AVM
💉Drug use: PRES, RCVS, Cocaine-related angiitis
🌓Psychiatric symptoms: Monogenic SVD, vasculitis
🧬Disproportionate WMH, lacunes: Monogenic SVD

#NeuroTwitter #NeuroRad #Neurology #Neurosurgery #stroke #MedStudentTwitter #FOAMncc #MedTwitter #FOAMncc #cSVD @PrCCordonnier @sophie_susen @Ellis_van_Etten @marco_pasi85 @gboulouis @EJouvent
via @StrokeAHA_ASA

[Michael Kentris, DO @DrKentris]

One of the most challenging yet essential skills to develop in the practice of medicine is the ability to think

The book "How to Think Like a Neurologist" by @emeltzermd does a great job introducing some foundational principles of neurology

Here's a summary:

[Mica Schachter, MD @neurona_critica]

When would you start anticoagulation after acute stroke in patients with A fib? Brief summary about the topic. Thanks @caseyalbin for your amazing and ultra-fast feedback!
@EmoryNeuroCrit @ELAN_Trial #Neurotwitter #Neurology #Neurocriticalcare #stroke

[Daniel Gewolb, MD @daniel_gewolb]

Imaging Quick Tips & Tricks for Cranial Neuropathies 🧠

A neuroimaging 🧵 on check areas and pathology

#neurology #meded #medicine #neurosurgery #ent #radres #futureradres @AlbanyMedRadRes @PennRadiology

[Andreas Charidimou MD, PhD @a_charidimou]

🧠⭕️ Ischemic Stroke ~ Major Causes

Huge thanks 🙏🏾🙏🏾 to @MicieliA_MD @caseyalbin @ShadiYaghi2 for great suggestions & feedback!!

#NeuroTwitter #NeuroRad #Neurology #Neurosurgery #stroke #MedStudentTwitter #FOAMncc #MedTwitter #FOAMncc #neuroscience #brain #CardioTwitter

[Julieta Rosales @J_Rosales_MD]

🔥 Here a brief resume of EVT trials of LARGE CORE strokes, a pocket table.
@NguyenThanhMD @TudorGJovin @ShadiYaghi2 @SposatoL @interneurona @ALATACV

[Lea Alhilali, MD @teachplaygrub]

When you’re asked to localize the lesion in a patient with aphasia, do you suddenly feel speechless?

At a loss for words to categorize the type of aphasia?

Never fear—here is the decision tree for patients w/aphasia and the associated anatomic correlates

Three main questions:

1. Fluency? Nonfluency indicates damage to the FRONTAL language regions anterior to the fissure of Rolando

2. Comprehension? Impaired comprehension indicates damage to the TEMPOROPARIETAL language regions posterior to the fissure of Rolando

3. Repetition? Impaired repetition indicates damage within the core PERISYLVIAN language zone

The answers will lead you both to the type of aphasia and the location of the lesion.

Keep this figure with you for quick reference—so when you’re asked about a patient with aphasia, you'll have a lot to say!

[Saketh Annam, MBBS @SakethAnnam]

Endovascular Treatment in Acute Basilar Artery Occlusion Stroke: A Brief Practice Update From the Society of Vascular and Interventional Neurology | Stroke: Vascular and Interventional Neurology https://t.co/0TO9TbQxOj

[AshuJadhav @AshuPJadhav]

Validation of the National Institutes of Health Stroke Scale in Intracerebral Hemorrhage | Stroke: Vascular and Interventional Neurology https://t.co/vGlmsN3fyE @StrokeAHA_ASA @svinsociety @SVINJournal

[Saketh Annam, MBBS @SakethAnnam]

Exciting Opportunity to join the fantastic team @umnstrokencc! If you're aspiring to be a neurology 🧠resident, passionate about stroke, and eager to dive into clinical trials and research, consider it! My time with this team made my residency a breeze. Apply now! #neurotwitter

[UMN Cerebrovascular & Neurocritical Care @UMNstroke]

Apply here: https://t.co/xzJy6ORZrX
-Please don't send -in multiple applications-

@NMatch2024
#neurotwitter

[Saketh Annam, MBBS @SakethAnnam]

Celebrating milestone in first week of inpatient stroke 🧠
NIHSS ✅
Identified Distal M1 occlusion ✅
Pushed TNK ✅ with Door to needle 💉 - 37min
Rushed to IR with TICI3
Pt recovered well with NIH 19 ➡️4 in 24hrs
@NeurologyWvu @WVURNI #NeuroTwitter  #stroketwitter #MedTwitter

[Saketh Annam, MBBS @SakethAnnam]

Left Atrial Appendage Thrombus Detected During Hyperacute Stroke Imaging Is Associated With Atrial Fibrillation | Stroke https://t.co/irNvy6DdgI

[Andreas Charidimou MD, PhD @a_charidimou]

🧠Infarcts / ⭕️Vessel occlusions

👌Indeed one of my favorite schematics @OGdukeneurosurg via @MayoClinic @mayo

#MedTwitter #MedStudentTwitter #MedEd #FOAMed #neurotwitter #Neurology #stroke #Neurosurgery #FOAMrad #NeuroRad #neuroradiology #radiology #radres #RadEd #FOAMncc #MRI

[Shadi Yaghi @ShadiYaghi2]

Stroke despite anticoagulation in #AF carries a high recurrence. Switching anticoagulants does not reduce the risk, neither does adding aspirin. #MedTwitter #stroke #MedEd https://t.co/a24GB5W2ub

[Daniel Gewolb, MD @daniel_gewolb]

Tips & tricks of DWI to help narrow the differential

Ddx:
Stroke
Abscess
Hypercellular tumor
Hematoma
Epidermoid cyst
Encephalitis
Seizure
Demyelination
Toxic/metabolic disorders
CJD
Other stuff I’m forgetting
#Neurology #neurosurgery #radres #MedTwitter #MedEd @TheASNR

[Amrou Sarraj @amrsarrajMD]

TIMELESS results presented at #ESOC2023 by Dr. Albers. TNK in 4.5-24 hours was safe but didn’t show benefit overall, no adjunctive benefit to EVT, a trend towards improved outcomes in M1 occlusion (secondary analysis) and increased complete recanalization at 24 hours @ESOstroke

[Dave Watson @wvheadachedoc]

What a wonderful time meeting with past, present, and future @WVURNI #Neurology faculty, residents, and students (and some extra friends like @TylerAllisonMD & @NiverGrant). #AANAM2023 @AANmember @wvstrokedoc @WVUMedSchool @DoctorAliRezai

[Aaron Berkowitz @AaronLBerkowitz]

🧠Neurology Tweetorial🧠I'm often asked about localization/diagnosis in the challenging clinical presentation MULTIPLE CRANIAL NEUROPATHIES. Here is my approach, what is yours #MedTwitter #neurotwitter @NMatch2023 @rabihmgeha @DxRxEdu @caseyalbin @AvrahamCooperMD @a_charidimou?