Maximiliano Hawkes, MD

@RafidMustafa @MayoClinic Well done guys, I hope this was the first of many, Cheers!

So grateful to wrap up the inaugural @MayoClinic Hospital Neurology CME conference with my dear friend and co-course director Dr. Michel Toledano. Thanks to the incredible faculty and staff that made this possible as well as our phenomenal audience. See you all again in 2027!

Great opportunity to train with one of the best!

@UPensato @StrokeAHA_ASA @DGutierrez__V Thanks for writing this letter, you’re voicing the concerns of many of us. Core is not the same as established infarct. Few would doubt that the CT hypodensity shown in the case would have a FLAIR correlate of the DWI and, beyond 6 hours, would not have qualified for most trials.

Would you attempt reperfusion (EVT) in this #stroke patient? We believe large core RCTs showed evidence of EVT benefit in pts with large core, not large SEVERE core. Take a look at our letter of concern on @StrokeAHA_ASA. @DGutierrez__V ahajournals.org/doi/10.1161/ST…

Rigby et al: Recognizing Intracranial Hypertensive Crisis in Leptomeningeal Disease: Insights from a Case of Dynamic Bone Flap Angulation Link: link.springer.com/article/10.100… @neurocritical #neurocritcare

Read the associated editorial, "Optimal Blood Pressure After Stroke Thrombectomy: We Are Not All the Same," by @mxhawkes and Rabinstein: neurology.org/doi/10.1212/WN…

@mayoclinicnccmn Welcome Brett!

We’re so excited!!!!!!

Check out our latest article exploring the advances in posterior reversible encephalopathy syndrome: pathophysiology, diagnosis, and treatment. authors.elsevier.com/c/1lbdf5FFzL42…

@sciqst @neurona_critica It still is a poor prognosis sign at 72hs, never early after resuscitation as in this paper.

It's indeed crucial to revisit traditional prognostic markers in light of new data. The absence of PLR has long been considered a poor prognostic sign, yet as you highlighted, it can lead to false positives. This study's findings on PLR and dilated pupils in the context of OHCA are compelling, showing a significant correlation with brain death. It raises questions about the criteria we use for assessing neurological outcomes. How might these findings change clinical practices? #Medicine For more in-depth biomedical insights and review capabilities, check out sciqst.com—an invaluable resource for professionals seeking to stay updated.

🏆 Why it matters Absent pupillary light reflex (PLR) after OHCA is a traditional marker of poor prognosis but it has false positives. 📍Bottom line Patients with absent PLR and dilated pupils had a higher incidence of brain death (34.8 % vs. 9.7 %, p < 0.001).

Is the effect of blood pressure lowering the same in all ICH patients? Maybe not…

@SposatoL Sometimes (very selected), but the recurrence rates are (very) high in all groups…

🧠 PFO Closure in Ischemic Stroke & TIA Patients ≥60y 🔗 doi.org/10.1177/239698… 📌 Single-center cohort, n=239 👴 120 patients ≥60y ⏱ 3.1y mean follow-up 🎯 Recurrent stroke rates ▪️PFO closure (≥60y): 6.1% (3/49) ▪️No closure (≥60y): 25.4% (18/71) 📉 aHR = 0.11 (95% CI: 0.03–0.49) ▪️PFO closure (<60y): 2.6% (2/78) ▪️No closure (<60y): 19.5% (8/41) 📉 aHR = 0.10 (95% CI: 0.02–0.50) 🛡 Safety ▪️Procedure-related events: 6.1% (≥60y) vs 5.1% (<60y) ▪️Periprocedural AF: 6.1% (≥60y) vs 3.8% (<60y) ✅ No significant differences 🤔 Thoughts ⚠️ No benefit seen in TIA subgroup (aHR = 0.43; 95% CI: 0.03–5.82) → underpowered? ⚠️ High recurrence in non-closure groups → Competing mechanisms? Selection bias? 👉 Are you closing PFOs in patients ≥60y with ischemic stroke?

Most viewed this week from @JAMANeuro: APOE epsilon ε4 is a significant risk factor for intracranial hemorrhage in patients with atrial fibrillation on apixaban. ja.ma/3TJHNb8

Genetic information can both inform pathophysiology and guide patient selection. Happy to share our new study on APOE e4 and risk of intracranial hemorrhage in AF patients anticoagulated with apixaban. Take a look! jamanetwork.com/journals/jaman… @NeurologyYale @YaleNeuroICU

Misdiagnosed,misinterpreted or not recognized.With initial polypharmacy excellent outcomes

@Kendall_Lee1 @k_scheitler @MayoClinic @MayoClinicNeuro Very well deserved @k_scheitler, congrats!

Congratulations to Kristen @k_scheitler for getting the SNS NSTP award. @MayoClinic @MayoClinicNeuro

Great collaboration with @mxhawkes at @MayoClinic looking at differential effects of BP reduction by location in #IntracerebralHemorrhage. Thank you @SanticlocMD for leading! @YaleNeuroICU link.springer.com/article/10.100…

Thrilled to see our new paper in print! 🧠📄 While intensive BP lowering helps in ICH, it’s unclear if both deep and lobar bleeds benefit equally. Take a look: link.springer.com/article/10.100… Immensely thankful to my mentors @GuidoFalconeMD and @mxhawkes

@SanticlocMD @GuidoFalconeMD Great work Santi!

I’m attending #AANAM April 5-9. Will you be joining me at my #neurology presentation Neurologic Complications of Critical Illness on 5/4 at 1.15 pm, Room 28-E? I can’t wait to see you in San Diego! @AANmember/@AANbrain @mayoneurores @mayoclinicnccmn

@GuidoFalconeMD @SanticlocMD @YaleNeurons @NeurologyYale @YaleMed @MrDisability @Yale_OAIC Congrats Santi!!!

Very proud of @SanticlocMD who matched at @YaleNeurons today! Super congrats, Santi! @NeurologyYale @YaleMed @MrDisability @Yale_OAIC