Chail Shah, MD

Finally my new #POCUS #IMPOCUS @kosmosplatform device is here :) :) Thank you #POCUS community for helping me find the perfect device :) #CriticalCare #vexus #FOAMed #MerryChristmas

Dr. Alex Valadka & team published "Treatment Algorithms From the Brain Trauma Foundation Guidelines for the Management of Penetrating Traumatic Brain Injury, Second Edition" in @NeurosurgeryCNS. #pTBI journals.lww.com/neurosurgery/f… @UTSWMedCenter @UTSWBrain #Neurosurgery

Our new work just published in Hearts: “Why and How to Measure Left Ventriculo-Arterial Coupling in Rapidly Altered Hemodynamic States.” VAC (Ea/Ees) links ventricular contractility and arterial load, helping explain why BP, EF or CO alone often mislead in shock. A step toward mechanism-guided haemodynamic management. 🔗 mdpi.com/2673-3846/7/1/… #CriticalCare #EchoFirst #POCUS #Hemodynamics

I built a free neurocritical care reference tool called NeuroBedside. 215+ landmark trials with trial details and one-line clinical pearls. 26 interactive relevant medical calculators. details of 23 scoring scales. Biostatistics reference. All in one place, on your phone or computer, at the bedside. No paywall. No login required to browse. neurobedside.com #NeuroCritCare #NeuroTwitter #MedEd #FOAMed #CriticalCare

Interesting #echofirst image SLE -> stroke 🫀👇 #POCUS #FOAMed Source 🔗CASE (Phila). 2020;4(6):507-511. doi: 10.1016/j.case.2020.09.005.

EMBOLISE: MMA Embo w ONYX in pts with sx subacute/chronic SDH #ISC26 @StrokeAHA_ASA - MMA embo w Onyx > observation in reducing risk of surgical rescue or poor/deteriorated clinical outcome at 90 days - no strokes/deaths from Onyx embo, rather comorbidites/procedural factors

No benefit with addition of TNK to EVT in basilar artery occlusion in the ATTENTION LATE trial. Sharing results of "negative" trials is critical to understanding and building on knowledge gained! #ISC2026 #negativeclinicaltrial #attentionlate @StrokeAHA_ASA

#ISC26 🚨Which ESUS patients benefit from anticoagulation? Subanalysis of ARCADIA and NAVIGATE-ESUS show that those whit left ventricular dysfunction benefit the most.

In large core acute ischemic stroke due to large vessel occlusion, severely hypoperfused tissue volume (Tmax >10s on CTP) predicts greater cerebral edema growth and serves as a strong imaging marker for edema progression. By @vsyedavalli 👇 doi.org/10.1007/s00062…

Simultaneous publication at #ISC26🔴: Cortical superficial siderosis burden is one of the strongest predictors of post-thrombolysis hemorrhage, disability, and mortality. Radiological Boston CAA criteria v1.0–1.5 increased ICH risk, while v2.0 did not. ahajournals.org/doi/abs/10.116…

Feil et al: Ketogenic Diet in Super-Refractory Status Epilepticus: A Retrospective Cohort Study with Severity-Matched Controls in Critically Ill Adults Link: link.springer.com/article/10.100… @neurocritical #neurocritcare

We spent a decade perfecting recanalization. CHOICE-2 reminds us outcomes don’t end at TICI 2b. EVT alone: “We’re done here.” EVT + IA tPA: “Let’s actually finish the job.” mRS 0–1: 57.5% vs 42.9% Absolute benefit 15%. p = 0.002 Microvascular no-reflow is real. CHOICE-2 just made it hard to ignore.

🧵/Late-breaking science results from #ISC26 will be posted to this thread at the time of presentation. (bookmark this post) CHOICE2 FASTEST CREST-2 OCEANIC-STROKE EMBOLISE LFAIS LB035

RESEARCH ARTICLE: Intracranial Stenting During Acute Endovascular Therapy of Stroke: Clinical and Radiological Outcomes of the RESISTANT International Registry ahajrnls.org/3ZaTGK6

#POCUS #Nephpearls #FOAMed #echofirst Advantages of TAPSE (Tricuspid Annular Plane Systolic Excursion) 🟢 Simple; less dependent on optimal image quality or clear endocardial definition 🟢 Good intra- and interobserver reliability 🟢 Validated against biplanar Simpson’s RV ejection fraction 🟢 Correlates with RV ejection fraction by 2D echo, radionuclide ventriculography, and CMR (gold standard) 🟢 Correlates with indices of RV diastolic function 🟢 Sensitive for detecting RVD in HFpEF 🟢 Robust predictive value across different diseases 🟢 Feasible in most patients, regardless of heart rate or rhythm Disadvantages of TAPSE 🔴 Assumes displacement of a single segment reflects global RV function 🔴 Angle-dependent and potentially load-dependent 🔴 Averaging multiple cardiac cycles can mitigate preload and heart-rate effects 🔴 Ongoing controversy regarding normal reference values (generally, ≥ 1.7 cm is considered normal).

Excited to share the next guideline in our Neuroprognostication Guideline series: Status Epilepticus. Congratulations on all the hard work. Thank you @neurocritical NCS for the support: rdcu.be/eYJlR @HopkinsMedicine @hopkinsneurons @HopkinsNCCU @epilepsysociety

We are trying something new!!! Tmw @neurona_critica and I are gonna do a ‘Live’ on Instagram to chat about how we are adapting our practices after #TRAIN trial! It will be super fun and casual. 💥1PM ET10/8! 💥 If you have Instagram you just click the live to come chat all things neuro-transfusion with us!

In patients with acute ischemic stroke treated with intravenous thrombolysis, early tirofiban improved functional outcomes at 90 days. Intracranial hemorrhage was uncommon but more frequent with tirofiban. Full ASSET-IT phase 3 trial results and Research Summary: nej.md/44nYCNS

Updates in NeuroCritical Care and Best practices #NCS2025

Time-to-treatment for patients with ICH is significantly longer than for patients with AIS. Faster antihypertensive treatment times are associated with better discharge outcomes in patients with ICH. 🧠 shorturl.at/qEjWv #SCCMNeuro #NeuroICU #NeuroTwitter #NeuroX

In patients with supratentorial intracerebral hemorrhage, minimally invasive surgery within 72 hours did not significantly reduce 30-day mortality or improve 180-day disability compared to medical management alone. ja.ma/3VtSrUo