Pietro Panni

We're winning the infection battle in aSAH. But we're losing ground on kidney injury and DVT. New data from 163,349 US aSAH hospitalizations (2006-2022) in Neurocritical Care: UTI and sepsis declined significantly. Infection prevention bundles are working.

Just read an interesting paper, "Long-term outcomes of poor-grade aneurysmal subarachnoid hemorrhage" New multicenter data (n=1,589) just published in the Journal of Neurosurgery looked at long-term outcomes in poor-grade aSAH. The headline finding was 51% long-term mortality. What I found more interesting, among patients who received EVD before aneurysm treatment, 39% showed clinical improvement (GCS increase) after drainage.

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Our @TheJNS paper is out: In perimesencephalic SAH, high-res CBCT frequently identifies a basilar perforator pseudoaneurysm supporting an arterial etiology until proven otherwise. Conservative management was associated with excellent outcomes. shorturl.at/qXet7

Efficacy and safety of minocycline in patients with acute ischaemic stroke (EMPHASIS): a multicentre, double-blind, randomised controlled trial - The Lancet thelancet.com/journals/lance…

From “Does EVT work for DMVO?”❌ to "WHICH patients benefit most?" ✅, we used explainable counterfactual model to move beyond "one-size-fits-all".🧐 🔗 onlinelibrary.wiley.com/doi/10.1002/an… 🔗 dusktool.streamlit.app @ANA_journals @NeuroprecisionL @PittStroke @PittNeurology @RaulNogueiraMD

@ShadiYaghi2 What exactly is “a significant mass effect on imaging”?

The new AHA acute stroke guidelines are out. These reflect comprehensive available evidence in acute ischemic stroke including systems of care, use of TNK, EVT eligibility, antithrombotic use, pediatric stroke, and management of cytotoxic brain edema. ahajournals.org/doi/10.1161/ST…

Intracranial Stenting During Acute Endovascular Therapy of Stroke: Clinical and Radiological Outcomes of the RESISTANT International Registry | Stroke: Vascular and Interventional Neurology ahajournals.org/doi/10.1161/SV… @StrokeAHA_ASA @SVINJournal @svinsociety

Within 6 hours, using CTP to rule out #thrombectomy in otherwise eligible #stroke pts not only harms pts but also worsens cost-effectiveness on the healthcare system.. jnnp.bmj.com/content/95/6/5…

@NeuroIRdoc Top biased, we treat earlier the most severe. Plus we need to consider rebleeding in poor grade. I will never be convinced by such studies

Treating aneurysmal SAH within the first 12 hours associated with worse outcomes, compared to 12-24 and >24 h. 🤔 That early period needs to be dedicated towards stabilization of pt medically/neurologically prior to pursuing endovascular approaches? link.springer.com/article/10.100…

Net Water Uptake at CT Predicts the Treatment Effect of Thrombectomy for Low ASPECTS Stroke | Radiology pubs.rsna.org/doi/10.1148/ra…

Hemorrhage and Risk Factors in Unruptured Brain AVM jamanetwork.com/journals/jaman…

Intracranial Aneurysm Wall Phenotypes: Clinical, Morphological, and Hemodynamic Influences | Stroke: Vascular and Interventional Neurology ahajournals.org/doi/full/10.11… @StrokeAHA_ASA @svinsociety @SVINJournal

Large Core Thrombectomy: Feasibility of Simplified Protocol in Resource‐Limited Settings | Stroke: Vascular and Interventional Neurology ahajournals.org/doi/full/10.11… @StrokeAHA_ASA @SVINJournal @svinsociety

We’re thrilled to share our new preprint unveiling a remote-controlled microballoon platform that lets us titrate carotid flow on demand while imaging the brain’s real-time response in vivo:) It could be transformative for the study of brain hemodynamics! biorxiv.org/content/10.110…

Aneurysm Wall Imaging and Risk of Growth and Rupture jamanetwork.com/journals/jaman…

Our last effort on poor grade aSAH from POGASH Registry! We never talk enough about delayed infarction volume!! link.springer.com/10.1007/s10143… @Brainresus @chiara_robba

Getting closer to a paradigm shift in the surgical treatment of non-acute subdural hematoma. Liu et al evaluated 69 brain CT scans to determine that the posterior MMA division accomodated a 0.027in microcatheter in >90% of cases, with perforation trajectories into high probability hematoma in nearly every case. They also shoed feasibility of aspiration of cSDH through microcatheter, which could potentially be combined with MMA embolization for subset of lesions. bit.ly/45jkfRg #cSDH #mmaembolization

When to start anticoagulation after an ischaemic stroke in people with atrial fibrillation? Attached please find a comment in the NEJM Journal Watch on our CATALYST meta-analysis, published in The LANCET. @BoNorrving @SignildAsberg