@akshay_sivaji92 @neelmed @guadalupefbv @JunParkSZMD @luisavictorial @CwruNeuro @TheNRMP @NMatch2026 Thousands of congratulations, Akshay! All the hard work paid off. Truly deserved!
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Alhassan Al Mostaneer
3.5K posts
Alhassan Al Mostaneer
@HSHM20
طبيب زمالة المخ والأعصاب | كليفلاند | الولايات المتحدة 🇸🇦 🇺🇸Neurology resident | UH Cleveland Medical Center @cwruneuro @UHhospitals #VascularNeurology
Cleveland, OH Katılım Kasım 2011
599 Takip Edilen2.3K Takipçiler
Beyond grateful to match at my dream program!!!!!
This isn’t possible without the support of my incredible mentors @neelmed @guadalupefbv @JunParkSZMD @luisavictorial
Excited for this next chapter @CwruNeuro @TheNRMP @NMatch2026 #Neurology #Match2026
Let’s gooooooooooooo
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Alhassan Al Mostaneer retweetledi
The right hemisphere would like a word. Turns out the right brain has been getting robbed.
Our new paper in @StrokeAHA_ASA shows right MCA strokes actually have worse inpatient outcomes than left.
Higher mortality.
More edema.
More complications.
Yet these patients often score lower on the NIH Stroke Scale.
If your stroke does not affect speech, the system sometimes thinks you are doing just fine.
Translation: patients with right hemisphere strokes can look “better” on paper while actually doing worse.
#Stroke #NeuroTwitter #Thrombectomy #MedTwitter
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@whitfieldlewis6 Thank you, Dr. Lewis for your valuable and enjoyable tweets.
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@HSHM20 As it causes posteriorly, it is lateral to the optic tract and provides blood flow to a segment of the optic tract, hence hemianopia.
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A 60-year-old male with diabetes and hypertension presents with an acute onset of right-sided weakness, right-sided sensory loss, dysarthria, right facial droop, and right homonymous hemianopia.
Given the homonymous hemianopia present, you suspect a large vessel occlusion.
However, CTH and CTA were both unremarkable; MRI Brian is shown below.
❓ Question: What branch of the supraclinoid ICA produces this symptomatology and infarction pattern on MRI? Drop your thoughts below 👇👇
Also, see my previous post detailing the 3 major branches of the supracilniod ICA below 👇👇
#Neuroradiology #Stroke #FOAMed
Whitfield Lewis, MD 🇦🇬🇺🇸@whitfieldlewis6
I'm sorry, it looks like the first image didn’t load. Here’s a clean lateral DSA of the internal carotid artery (ICA) to walk through the supraclinoid branches with the text below. 👇👇 Small branches. Massive consequences. Before the internal carotid artery (ICA) bifurcates, let’s walk through the key supraclinoid branches on this lateral DSA. Anchor yourself here. Follow along. The internal carotid artery supplies the anterior and superior brain. The vertebral and basilar system supply the posterior and inferior brain. This is a lateral diagnostic cerebral angiogram of the ICA. Remember: DSA subtracts tissue and only opacifies vessels. You are looking at the complete filling of the internal carotid artery. Left of your screen = anterior brain. Right of your screen = posterior brain. Now pay attention to the arrows. Just beneath the arrows, where the artery curves anteriorly, is the carotid siphon. This segment runs through the cavernous sinus. It is called the cavernous segment of the ICA. The ICA then pierces the dura mater superiorly at the level of the anterior clinoid process and enters the intradural space. That is why this segment is called the supraclinoid ICA. Get it? The first major branch after it enters intradural space is the ophthalmic artery (green arrow). This artery runs anteriorly. Why does this matter? A clot from a carotid plaque can embolize into the ophthalmic artery, then into the central retinal artery → sudden, painless monocular vision loss. Another major branch, labeled purple, is the posterior communicating artery (PComm). This vessel is part of the circle of Willis. It connects the ICA to the posterior circulation by joining the posterior cerebral artery. Now look closely. Running parallel to the PComm is a much smaller vessel, the anterior choroidal artery (red arrow). It is small. But an occlusion here can mimic a large vessel stroke. Why? Drop your thoughts below. 👇👇 #Neurology #NeuroTwitter #Stroke #DSA #Neuroanatomy #FOAMed Image source: Guzmán Pérez-Carrillo & Hogg. Curr Probl Diagn Radiol. 2010.
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@whitfieldlewis6 Yes, DWI changes on the left posterior limb of internal capsule and left hippocampus.
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@HSHM20 This is perfect. Thanks. Do you appreciate the pattern on MRI?
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Alhassan Al Mostaneer retweetledi
💡 #ISC2026 Highlights Webinar with @WorldStrokeOrg, @American_Heart, and ESO
📅 Date: 24 Feb
🔗 Register: us02web.zoom.us/webinar/regist…
👉 @LaurenHSansing, @jeyaraj_pandian
📢Craig Anderson, @carlosmictusvh, @HanneKChr @amrsarrajMD
#Stroke @American_Stroke @WorldStrokeEd
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Honored to present at the International Stroke Conference 2026. Grateful for mentorship, these opportunities only happen when you’re guided by the very best in the field. @amrsarrajMD
#ISC26
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Alhassan Al Mostaneer retweetledi
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.
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Alhassan Al Mostaneer retweetledi
Alhassan Al Mostaneer retweetledi
Main Event @StrokeAHA_ASA #ISC26
CHOICE-2 trial: use of IA tPA after successful IAT with TICI-2B/c
Just do it ✔️
NNT 7
No significant ICH difference
50% were TICI 3
2/3 received IV thrombolysis
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Alhassan Al Mostaneer retweetledi
#ISC2026 day 1 clinical trials summary. CHOICE2 study: Intra-arterial thrombolysis showed a remarkable difference in outcome, but why did the mortality increase? @StrokeAHA_ASA
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Alhassan Al Mostaneer retweetledi
🧵/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
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Alhassan Al Mostaneer retweetledi
#STROKE Guidelines in Action 🗒️: Mobile stroke units enable ultra-early stroke care with faster IVT, higher IVT rates, and improved 90-day outcomes without excess harm. CTA-equipped stroke units improve LVO triage and reduce door-to-puncture times. ahajournals.org/doi/full/10.11…
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Alhassan Al Mostaneer retweetledi
#STROKE Guidelines in Action 🗒️: For mild non-disabling stroke ≤4.5h, IVT is not recommended. DAPT should be considered to reduce early recurrence. Ticagrelor + aspirin may be an option in selected patients with noncardioembolic stroke. ahajrnls.org/4raYcnM
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Alhassan Al Mostaneer retweetledi
Do not missed the new chemic ischemic stroke AHA incorporating the latest evidence to help guiding the care for strong patients worldwide. Fresh from the press!!! ahajournals.org/doi/10.1161/ST…
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Alhassan Al Mostaneer retweetledi
#Mondaytip
🧠 New @American_Stroke #Stroke Guidelines
✔️ TNK = first-line option for IVT
✔️ EVT expanded (large cores & basilar ≤24h)
❌ No aggressive BP or glucose lowering
👶 First pediatric AIS guidance
⏱️ Systems of care matter more than ever
doi.org/10.1161/str.00…
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@MajedAAlomar الف الف الف مبروك يبو عبدالمحسن، تستاهل كل خير يالغالي 🙏🏽👏🏽
العربية
حصلت بحمد الله على البورد الأمريكي في طب وظائف الأعصاب وتخطيطها، ومنّ عليّ المولى أن أكون ضمن أعلى ٣٪ من المتقدمين للبورد.
الشكر والتقدير لأساتذتي وزملائي الكرام على دعمهم، ونسأله تعالى التوفيق والسداد.
العربية
It’s an honor and a privilege to work and learn from the best in the field of stroke neurology. @amrsarrajMD
Cleveland, OH 🇺🇸 English