Видео

What if you have no risk factors and still have lesions? Genetics?

Joe has followed the trajectory of my father in law exactly..my father in law passed in Early April Just after Easter. ☕🌷🙏🇺🇲

Just great talk and interviews by these notable doctors on the subject of strokes.

Stroke and environment has synergistic relation

In 1998 (age 39) I had a carotid dissection and a hospital induced stroke following the misdiagnosis,and treatment of my TIA as a migraine [immitrex shot and IMMIDIATE stroke]. Sucked, but, after 6 - 9 months, no serious lingering symptoms except crazy hypertension (190/130) which is reducing year over year, now 140/80 (if left unmedicated). For 5 years following my ICA was 100% occluded but at some point in the intervening 20 yrs my iCA opened up (I just found this out). Guess I was lucky that my stroke was caused by the temporary restriction of blood flow caused my the immitrex shot not a clot. I just had to learn to speak and spell again, had,left,side weakness, but that disappeared really quickly, within days after waking up from a 3 day coma. Now 66, I’ve been on hypertension meds for 25 years .. no big deal, seems amazing luck that dissections and strokes happen when one is young, I have to imagine it’s way easier to recover and regain function. Good luck to anyone that suffered a dissection and stroke … i had a form of PTSD following release from hospital, was convinced that every headache or weird feeling was another stroke, I had panic attacks many when flying to various parts of the world, while still taking 7.5mg Coumadin and getting PT/INR tests in crazy places., maybe with new drugs, there is less chance of bleeding from an injury … I think the constant reinforcement about Coumadin and brain bleeds cause some of the anxiety … I did travel for business within 8 weeks of the stroke to,Asia … had no choice … but survived. Oddly it was easier to get the PT/INR tests in Singapore and Hong Kong than it was in Australia. I took me about a year for the panic attacks to quieten down, even though I had good methods to deal with them after 3 years (maybe earlier) , the whole thing was a distant memory. I fully recovered speech and spelling. I trail run 4mi/day and occasionally my left foot will catch a rock … some small laziness maybe an artifact .. but … no big deal I never see chiropractors .. and am still cognizant of keeping my neck in one position (up or down) for anything more than a few seconds. The doctor that misdiagnosed eventually lost his medical license .. that was good to hear. I hope this story helps someone … a dissection and stroke when young is very recoverable. Good luck to you all.

very useful thanks, I had an ICA Right side at skull base in Feb 2024

❤

Sadly, I lost my dad 2-3 weeks ago to a brainstem stroke. Devastating….it took him right out until he was declared brain dead…I’m having the most daunting time in my life with losing both parents in three years and my son losing ALL of his grandparents within the same three years. I promise this feels like a curse and I’m just lost about it all

🤰 Claudia in the first slide 😂 😂

YO THIS INTRO SLAPS HARD AF!!!!!

Interesting, I suffered a dissection and minor strokes in 2017.

What about thrombolysis in extended window period time.

Thanms for informative webinar

Thanks for sharing i was wondering what a stroke would feel like to have one, hope you have a blessed year 😊 John 3:16-21

I sometimes wake at night and my eyes cross and everything gets really dizzy. I can't move or feel anything. after a few seconds I feel better. A stroke?

Are the references white matter lesions the same as white matter lesions shown on imaging with migraine sufferers?

Thank you both for sharing this information.

I have had a cerebellum stroke and did not know until I had an MRI for another reason

One of the best explanations i had ever seen for posterior fossa strokes!

Very useful ; Thank you.

Louder please!

I had neck ultrasound so I hope they are correct when saying it was normal if it's not as good as CT. 😟

My daughter who is 19 years old was already on aspirin since after her first heart operation when she was only two months old baby. But last April,January, now in last week weeks she had 2 more TIA attacks. Recently they did MRI eventually and diagnosed TIA. just few days ago they replace aspirin with Warfarin.😢

Great

please somebody help. one of my family is affected by this. After the attack lasted for 2 to 3 min, we seek medical attention within 15 minutes and our doctor started treatment within 2 hours, mainly by medication. He didn't gave us tpa injection. What can we do as a family to keep the risk at minimum at all times? what are our options within the next 2 - 7 days? 🙏🙏🙏 somebody help

Dr.Nguyen is such a gentle neurologist.

Great! Thanks for the overview

Outstanding!! one of the best videos

Very helpful information as i am struggling with spasticity but fortunately am receiving Botox every 12 weeks

AMAZING THANKS

Great discussion, enjoyed it very much!

A nice job on a difficult topic. I have a few comments, as the evaluation of the dizzy patient in the ED has been a keen interest of mine for the past 2 decades. HINTS (and HINTS plus) is meant to be used for patients with acute onset spontaneous nystagmus AND nystagmus at rest. I made a video about this point. ruclips.net/video/L4nOD8YdV-s/видео.html By not including spontaneous nystagmus in the definition of Acute Vestibular Syndrome (AVS), it unfortunately will allow BPPV patients, who often complain of a mild baseline dizziness even at rest, of being subjected to the HINTS exam. Since BPPV patients don't have a vestibular nerve problem, their Head Impulse Test (HIT) will be normal and will have an overall HINTS central result, leading to inappropriate diagnostic imaging and treatment. You can see this happening in real life in the recent study by Gerlier pubmed.ncbi.nlm.nih.gov/34245635/ where despite trying to limit the inclusion of BPPV patients by excluding patients with no symptoms at the time of examination, BPPV was the most common diagnosis made, and the HINTS exam suffered in specificity due to the high number of false positive HINTS exams. Since all patients with vestibular neuritis have spontaneous nystagmus in the first several days of their illness and posterior canal BPPV does not have spontaneous nystagmus, then using the strict definition of AVS to include spontaneous nystagmus will maintain it's ability to discriminate between vestibular neuritis and a stroke presenting with AVS and nystagmus. Jonathan Edlow, one of the authors of the first Titrate papers, has in more recent papers pubmed.ncbi.nlm.nih.gov/31765116/ advised performing the HINTS exam on patients without nystagmus, but also that it is not to be relied upon when no spontaneous nystagmus is present. This makes no sense to me. Since if you don't have nystagmus, and you can't rely on the HIT, then applying HINTS to patients without nystagmus is not the HINTS exam, it is the TS exam, and the test of skew should not be used alone as a decision tool. The other point is that looking for red flags (what I call central features) is not the second thing to do after the HINTS exam, but in fact in the first line of defence in looking for a stroke. Only after screening negative for central features (new significant headache or neck pain, focal weakness or paresthesia, diplopia, dysarthria dysmetria, dyphonia, dysphagia, spontaneous vertical nystagmus, inability to walk unaided) should the HINTS plus exam be applied, and those with an overall HINTS plus peripheral result can be safety sent home. And what of the patients with constant dizziness and no nystagmus? Machner pubmed.ncbi.nlm.nih.gov/32462345/ described the Acute Imbalance Syndrome where patients were persistently dizzy in the ED, had objective findings with difficulty walking/balance, but no nystagmus. These patients are at high risk for stroke. Likely those who complain of constant dizziness, screen negative for central features, have no nystagmus or difficulty walking are at very low risk and are safe for discharge. Of course, assuming they aren't suffering from a general medical cause of dizziness such as G.I.bleed or arrhythmia, etc. Vertigo, with its specific bedside testing and resultant eye findings is one of the most dynamic and dimensional aspects of the physical exam in all of medicine. I always wonder why so few videos demonstrating the techniques and nystagmus accompany lectures on vertigo, especially on platforms as well suited for it as youtube. If your viewers want to see my take on HINTS plus, they can have a look at my channel ruclips.net/user/PeterJohnsvideos Peter Johns Department of Emergency Medicine University of Ottawa

Excellent speakers ! Thank you for making it available

Thank you for share!

O ya I first'here to see that

thank you for your webinar. it is so useful for me!

For those interested in cerebellar stroke syndrome, he ran out of time and did not discuss it. See 17:53 timestamp.

Wonderful explaination