Dr. Samarth Gowda

If there was one article you want to read as a clinician? Read this Via @jenna_taglienti - an absolutely stunning write in @JAMA_current "Medicine can have extraordinary meaning. But it cannot substitute for being present in your own life. The world may need us as physicians. But the people who love us need us as ourselves. And that is the role no one else can fill." Brilliant - and much love to you 'Time is Finite" jamanetwork.com/journals/jama/…

🚨 New study in Clinical Neurology and Neurosurgery on aneurysmal subarachnoid hemorrhage (aSAH) management 🩸 🧠 Anticipatory initiation of Intrathecal Nicardipine (ITN)—given before clinical or imaging evidence of delayed cerebral ischemia (DCI)—significantly reduces DCI parenchymal infarcts compared to controls (31.3% vs 55.2%). Key findings: 📉 Starting ITN prior to intra-arterial (IA) spasmolytics significantly lowers the need for serial IA treatments for recalcitrant vasospasm from 71.4% down to 23.1%. 🛡️ It is a safe intervention with no increased risk of EVD-related complications or meningitis. ⚠️ Timing is everything, because reactionary ITN given after DCI onset did not reduce the rate of additional infarcts or the need for serial IA treatments. Question: Does this article change your practice? #NeuroTwitter #NeuroCriticalCare #SubarachnoidHemorrhage #Vasospasm #NeuroSurgery sciencedirect.com/science/articl…

How to remove stuck perclose, must watch for 1:2-3000 scenarios #Cardiotwitter #IRAD Outstanding video by Mike!

Algorithm for management of acute ischemic stroke eligible for EVT DVO: distal vessel occlusion EVT: endovascular thrombectomy IDD: insufficient data to determine LVO: large vessel occlusion mRS: modified Rankin scale MVO: medium vessel occlusion

Moderate consumption of caffeinated coffee or tea was linked to reduced #dementia risk and modest improvements in cognitive outcomes; no benefit was seen for decaffeinated coffee in an observational study of US adults. bit.ly/4amtd1c

Radiologist is the "New Internist". With so much advance treatment available...pts can't wait till they develop full blown symptoms for the "clinical skills to act". Radiology is the new clinical skill to diagnose problems and institute effective pt management. #MedTwitter

Is trying to remember toxic encephalopathy patterns making you toxic? Does memorizing metabolic encephalopathy patterns put you into a metabolic coma? Don't become encephalopathic! Here is the cheat sheet of the encephalopathy patterns you NEED to know & how to remember them! ➡️Corpus Callosum: 🔸Lesions here are called cytotoxic lesions of the corpus callosum or CLOCC. 🔸Usually transient from cytotoxicity, especially viral infections. 🔸Remember they are commonly viral & transient bc CLOCC lesions are on the CLOCK ➡️Central Pons: 🔸Usually osmotic demyelination 🔸Remember this bc the T2 hyperintensity is in the shape of O for Osmotic ➡️Dentate: 🔸Usually flagyl toxicity 🔸Remember this bc the wavy appearance of the dentate looks like a FLAG for FLAGyl ➡️Corticospinal tract: 🔸Usually from cobalamin deficienty 🔸Remember cortiCOspinal for CObalamin ➡️Symmetric Gray Matter: 🔸Differential is EXTENSIVE 🔸Remember the differential list for deep gray is deep! ➡️Cortical Gray Matter: 🔸Typically hypoglycemia & hyperammonemia 🔸Remember it looks like the brain has been coated in shimmering sugar = related to glucose 🔸Hyperammonemia has about 1000 Ms in it & the undulated cortex looks like an M ➡️Symmetric White Matter: 🔸Commonly from chasing the dragon (heroin) & methotrexate 🔸Remember that the puffy white matter signal looks like the smoke from a dragon 🔸Remember methotrexate as methoTRACTSate = affects many white matter TRACTS ➡️Posterior subcortical edema: 🔸This is PRES or posterior reversible encephalopathy 🔸So if it’s all POSTERIOR, think POSTERIOR reversible encephalopathy ➡️Asymmetric White Matter: 🔸This is usually demyelinating from chemotherapy 🔸Demyelinating lesions have a C shaped pattern of enhancement 🔸So if you see a C enhancing think of C-hemotherapy Now you know all the toxic/metabolic encephalopathy patterns. So hopefully now remembering the patterns of toxic/metabolic won’t seem so diabolic!

⭐New open access paper!⭐ This multi-institution collaborative review on the role of epidural blood patching in CSF Leaks is an important addition to the literature: neurology.org/doi/10.1212/CP…

✅Cortical vein sign: cortical veins located adjacent to the inner table. In BESSI/cerebral atrophy ❗️Displaced cortical vein sign: cortical veins running separated from the inner table. In subdural collections. ⬆️Relevant in pediatrics. See what´s necessary & what´s superfluous

Focused update to guidelines for endovascular therapy for emergent large vessel occlusion: basilar artery occlusion patients jnis.bmj.com/content/early/…

@YNIScommittee The Cavernous sinus!

Can you name the following structure? #neuroanatomy

"🌟 Calling all radiology residents and medical students interested in Interventional Radiology (IR)! 📚 Join ISVIR's exclusive online masterclass on May 12th, featuring top speakers and insights into the world of IR. 🎓 Register now: 🔗 zurl.co/odUg

Case of the Week: Dural AVF how do you like to treat? Arterial, Venous, or Both. All depends on what the anatomy gives you. @BannerHealth @PenNeuro @SNISinfo @svinsociety @esmintsociety

🧠 Do you have aneurysmal subarachnoid hemorrhage patients who remain debilitated with long-term neuropsychiatric outcomes despite successful aneurysm treatment and "good" functional outcomes? New review from @DanniDiestro @SmhNeuroVasc bit.ly/3xCGq6w @BAFOUND

Management of SAH: an update for the intensivist bit.ly/3VSmCG8

@SNISinfo @esmintsociety @cvsection The Central retinal artery!

Check out this lateral angiographic picture highlighting a branch off of the ophthalmic artery. Can you name it? @esmintsociety @cvsection #MedTwitter

#SundayRead In this #LettertotheEditor, the author shares his experience on providing a sustainable 24/7/365 interventional radiology service - incl. sufficient manpower resources, making time for family, consistent work processes, and more: cvirendovasc.springeropen.com/articles/10.11… #IRad

Importance of completion venogram from splenic hilum. 42y/M, CLD, EV and GOV2, refractory variceal bleed, for rescue TIPS. Supply from LGV, PGV, SGV. LGV glued. Angio from SMV clean. Completion run from SV showed persistence of PGV and SGV. Both glued. Proximity theory ❤

We've wrapped up General IR, Gastrointestinal IR, and Onco IR series in the ISVIR Masterclass. Now, get ready for our NEURO IR series! With 30+ topics spread over five months, two sessions / week. Don't miss out on any updates - simply fill the form forms.gle/yLneHfftauJpSm…

Article Commentary: “Dental Caries, Race and Incident Ischemic Stroke, Coronary Heart Disease, and Death” ahajournals.org/do/10.1161/blo… In this #BloggingStroke post, Courtney Curran discusses #Stroke article by @SouvikS57356262 et al. @elizalavalley @gottesman_lab