Shashank Nagendra

Forty 40% of LVO pts with successful recanalization (TICI >2B) experience a spontaneous SBP drop (>40 mm Hg over <1 hr) over the next 24 hours. These drops are associated with poor 90-day functional outcome and early neuro deterioration (22% bs 13%). Unclear if the lower BP is driving the neuroworsening, or a biomarker of a fading pressor response due to adequate reperfusion. neurology.org/doi/10.1212/WN…

Degree of narrowing is not the whole story. High-risk plaque features—intraluminal thrombi, webs, and dissections—are strongly linked to ipsilateral stroke in nonstenotic carotid disease. @Katha_MD @hankshas @AlmekhlafiMa @draravindganesh @nishita_singh3 ahajrnls.org/4kC5Wxc

🚨Nonstenotic carotid disease is often seen in stroke. In this @ActRrct paper led by @Katha_MD @nishita_singh3 we show that in such patients, intraluminal thrombi, webs, dissections & rim sign are strongly assoc with ipsilateral stroke @JAHA_AHA @DCNSNeuro ahajournals.org/doi/full/10.11…

@SharathKumarGG7 @ManipalHealth Great case sir. How do you manage to get the 088 across the stenosed segment? Most of the time its difficult to even get the balloon across.

Refractory IIH with CSF Rhinorrea treated with Venous sinus Stenting successfully @ManipalHealth Venous Manometry showed pressure gradient of 11mmHg. VSS is 2nd line of management in IIH and it deserve better recognition. Technically very simple #IIH #Neuroradiology #Neurology

@aditya_gan3500 @witchdrkochi @MicieliA_MD These patients were studied in the tempo 2 trial. Showed antiplatelets equivalent to TNK with demonstrable intracranial occlusion. Here the patient has Afib as well. So anticoagulation can be considered although we need more data.

@witchdrkochi @MicieliA_MD NIHSS 2 with only mild dysarthria This would be disabling stroke for a public speaker or singer I would consider IVT only for a patient with that kind of profile

Code stroke🚑 Patients presents 2 hours from onset of mild dysarthria, left facial weakness (and resolved L sided weakness)- NIHSS is stable at 2. CTA ➡️right M3 occlusion. ECG shows new afib. Neurologist starts them on DAPT. What do you think? #MedEd #neurology #stroke

@SharathKumarGG7 Nice case. Which catheter do you recommend for venous manometry?

Venous Sinus stenting is rapidly emerging as an alternative treatment to medically refractory IIH cases [pseudotumor cerebri] cases. Dedicated venous stents like River & Boss stent will be available soon & will be a game changer! Awaiting results of 4 RCTs! #IIH #Neurology #BIH

@SharathKumarGG7 Great cases! Thanks for sharing. Any opinion on type of stent [ (CGuard) vs closed cell vs open cell] given the different pathophysiology at play?

Carotid Web has ~26.8% recurrent stroke risk inspite of the best medical management! CAS has excellent outcomes & no recurrence in the literature reviews as well. Same with this representative case & patient is doing fine on 3 yrs followup! #CarotidWeb #Stroke #Neurology

@ShadiYaghi2 Thank you!

@hankshas Should not be different than cerebral venous thrombosis. Here is a statement by the AHA on CVT! ahajournals.org/doi/10.1161/ST…

Cortical vein thrombosis is a very challenging diagnosis to make. Imaging findings = hyperdense cortical vein & cashew nut sign (juxta-cortical hemorrhage) on CT. MRI with SWI is the gold standard (below). Make sure to look carefully at all cuts including topmost! #stroke #CVT

@Atirahcus @ihs_official @Simona_Sacco_ Fantastic @Atirahcus . Many congratulations!

@ihs_official Thank you @ihs_official and @Simona_Sacco_ Wendy Krank for all your help and support. I am grateful to be a part of the team and hopefully will continue to be a part of the same in the future as well.

🎉 Congratulations to the exceptional early-career researchers who have completed the 2024 - 2025 Cephalalgia Reviewer Academy! 👏 This inaugural cohort has demonstrated excellence, dedication, and a deep commitment. 👏 A heartfelt thank you to our outstanding mentors - Anna Andreou, Gianluca Coppola, Teshame Monteith, Kuan-Po Peng, Cristina Tassorelli, Marcelo Valença, and Simona Sacco - for sharing their expertise and guiding the next generation of reviewers. 🌍 From diverse backgrounds and across the globe, these eight talented individuals are now ready to contribute to elevate scientific publishing in the headache field. 🔎 We look forward to seeing their continued contributions to Cephalalgia and Cephalalgia Reports - and to welcoming new applicants to the 2025–2026 edition! doi.org/10.1177/033310…

Please to share our experience with Tenecteplase at our centre #TNK #AIS

@nishita_singh3 @JournalCJNS @amyyu_md @DrTejasSankar Congratulations!

I am excited to take on a new role as Associate Editor for @JournalCJNS at the start of this new year!💫 Big shoes to fill in as taking over from @amyyu_md 😊. Thank you @JournalCJNS & @DrTejasSankar for the opportunity!

@SharathKumarGG7 @ApolloKarnataka Interesting case. Thanks for sharing. Does the pulsatile tinnitus resolve completely post procedure?

Idiopathic Intracranial Hypertension [#IIH] associated venous stenosis & sigmoid diverticulum causing intractable #tinnitus, treated by #coiling of the diverticulum & #Stenting of #Venous #stenosis successfully. Instant cure for an elegantly treatable condition @ApolloKarnataka.

@doctorboletoh Congratulations!

So cleared MRCP PACES exam today! I thank GOD for showing me the right path to it, my parents and my wife who helped me walk on it and my patients who helped me learn through them!!

Time to give birth to a new idea! Need a way to remember the neuro complications in pregnancy? Try this baby step to help you remember the most common Neuro complications in pregnancy that we see on imaging! Just remember the four “P”s of “P”regnancy! They are.. ▶️Palsy (Bell’s) ▶️PRES ▶️Plugged up venous sinuses ▶️Pituitary apoplexy Of course, there are many other neuro complications in pregnancy, but these are the classic ones you always need to think about Hopefully, now the four P’s will give birth to a new era for you when it comes to imaging pregnant patients!

@Atirahcus @Shireen0701 @abgohel @FA_PGI @D_NEuRO All the best to the team!

All the best to @Shireen0701 and #TeamICTRIMS2024 Lets make it a success @hankshas @abgohel @FA_PGI @D_NEuRO

@drrhaul @DrSanjay277 Happy birthday!

@DrSanjay277 Thank you Sanjay 🙏🏽

Happy birthday 🎈🎁 🎂 Interventional Radiologist @drrhaul #MedTwitter #MedX

35 yr F presenting with a single focal seizure, no headache with CT showing focal edema in the right frontal cortex. DSA showing an isolated thrombosed vein of Trolard with intact Supr Sagittal sinus. What is the natural history and optimal duration of anticoaguln?

A variation not seen very often. Prominent anterior meningeal artery in a non operated individual.

@Vighrane01 Good pick up @Vighrane01 . The patient recovered completely with lysis with TNK and did not need thrombectomy.

24 year old. MCA infarct. 👀