1/ So now it's the cataclysmic TTM -2 trial, just published in @NEJM. How can a world changing trial like HACA published in 2002 now be effectively reversed almost 20 years later? I will explain. nejm.org/doi/full/10.1056/NE…

#TIA pts with an ABCD2 score of 0-3 and an MRI (-) for DWI ischemia have only a 1% chance of having a stroke over the next 90 days. Send them home! The risk approaches 5% with an ABCD2 score of 4-5 and DWI (+) MRI. Follow more closely! Nice informative data to talk to your pts about… neurology.org/doi/10.1212/WN…

A small but cool study demonstrating that Cenobamate (Xcopri) can be highly effective for terminating refractory and super refractory focal onset status epilepticus. 28 patients were treated after a median of five proceeding anti-seizure meds, 82% experienced sensation of status for >24 hrs compared to 56% in a matched cohort analysis. Something worth thinking about trying! #curingcoma neurology.org/doi/10.1212/WN…

Arterial spin labeling can demonstrate hyperemia in the region of a spontaneous #ICH and has excellent sensitivity and just about 100% negative predictive value for decreasing AVMs and DAVFs. A great way to screen for selecting pts for angiography. #CodeICH neurology.org/doi/10.1212/WN…

Watch this emotionally powerful video by my good friend Dr Sachin Agarwal of @ColumbiaNCC On May 10, 2026 he suffered an unwitnessed bicycle accident, sustained a severe cervical spine injury, and went into cardiac arrest. Two bystanders started CPR and saved his life -- he woke up the next day. Ironically, Sachin is a cardiac arrest researcher himself. is focus is on post-arrest survivorship. Now he's a survivor. He says "My experience has deepened my purpose. To use what I've learned from my journey to help others walking this path." Well said, and very inspiring, my friend. @neurocritical @WMCHealth @nymedcollege #curingcoma #NCS2026 piped.video/watch?app=deskto…

In this Bayesian meta-analysis of RCTs, a Hb transfusion trigger of <9 md/dl was associated with a greater likelihood of good functional outcome, with no effect on mortality, infections or thromboembolic events. #curingcoma link.springer.com/article/10…

Prone positioning patients with incracranial monitors results in a transient increase in ICP (mean 5 mm Hg), but improves systemic and brain tissue oxygenation. It's okay to prone. The monitor will make sure it's done safely. #curingcoma link.springer.com/article/10…

ICU Mobility - The Key To Survival After Critical Illness #ICURehab

In this trial of LVO patients presenting 24-72 hours after LKW with imagable penumbra, thrombectomy improved the likelihood of favorable functional outcomes (common odds ratio 1.74), but at the cost of excess ICH (5% vs 0%) and death (5% vs 2%). Kinda feels like rolling the dice..... Mechanical Thrombectomy 24 to 72 Hours after Large-Vessel Ischemic Stroke @NEJM #curingcoma nejm.org/doi/abs/10.1056/NEJ…

Now it can be told. The only good vessel is an open vessel. Even if the stroke is mild. I have never understood untreated “LVO watch” in the ICU. You are only asking for trouble.

Neurosurgeons still have a bias against patients with left-sided #ICH In 2 major clinical trials — ICH patients with right-sided bleeds were more likely to undergo surgery or EVD than left-sided bleeds Outcomes were the same but this remains a huge life-or-death issue for MCA infarction patients, where it’s well documented that this happens all the time. What do you think? #LivingWithAphasia @namorrismd ahajournals.org/doi/abs/10.1…

Is MMA embo now the primary treatment of choice for chronic SDH (cSDH)? More important than treating the presenting neurological deficit? This non-randomized comparative effectiveness cohort study looked at it this way. They tried to look at the impact of concurrent SDH drainage when added to MMA embo. They studied >2000 pts undergoing MMA embo for cSDH. About 40% also underwent burr hole drainage. Among those with a baseline mRS of 0-1 (no disability) the rate of complete recovery (mRS 0-1) was the same if you underwent drainage or not. No surprise. Among those with baseline mRS ≥2 (due to the blood clot pressing on the brain), those who underwent evacuation of the hemorrhage had a better 90-day rate of full recovery (mRS 0-1) than in those where the blood was left there to compress the brain: 30% vs 23%. Significant. Refer to this data in case you run into a patient with a hemiparesis or focal deficit due to a chonic SDH compressing the brain when the surgical plan is to do the MMA embo, yet and leave the blood in to continue to press on the brain. I have seen and am hearing more and more about this practice. Have you seen this too? jnnp.bmj.com/content/early/2…

If you are in Seattle at #NCS2026 come check out #TheCodes — this is the bands 20th year anniversary playing NCS — tonight at Baba Yaga, “Seattle’s premier rock n’ roll clubhouse.” Open bar and food. Doors at 8, music at 9 PM. 124 S Washington Street, walking distance from the convention center. Sponsored by #Phagenesis This is us after practice last night!

📊 Lost in the world of statistical tests? The right test depends on your research question, data type, distribution, and study design. From t-tests and ANOVA to Chi-square, correlation, and regression, choosing the correct method is the first step toward reliable conclusions.

Do you get your ventilated patients out of bed to a chair? rdcu.be/EFDMwkp7ufva @yourICM

Thanks for sharing and contributing to the discussion! 💚🧠

Nice review of the Role and Usage of Corticosteroids in Modern Neuro-Oncology Care Decadron for brain tumors (mostly gliomas) is essentially a #neurocriticalcare tool to help someone get through a tight spot with regard to acute swelling and mass effect. Use the lowest effective dose. Preferably once a day but if BID make the 2nd dose early like 3PM because actually interferes with sleep. (I know from experience treating a knee injury skiing. It made me a manic insomniac). Stop decadron as soon as possible. Long term use can be toxic — muscle wasting, hyperglycemia, infections and the like. neurology.org/doi/10.1212/CP…