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The NIH Stroke Scale is beneficial when used correctly but is has its limitations. Relying entirely on the NIHSS will miss significant disability in a number of patients. Acute stroke care demands more than just an NIHSS assessment.
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What Lessons Have You Learned About Endovascular Therapy in COVID Patients and What Should We All Know?

December 2, 2020
Acute interventional management during the COVID pandemic requires a change of focus and practice. Challenges abound and danger exists at every decision point.
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Controversies in Prehospital Medicine: Choosing the Destination Medical Center for Stroke Patients

December 2, 2020
Once a stroke is suspected in the field, it stands to reason that the destination matters for the patient. But how much does it matter and where should patients be taken? Data meets politics in this compelling podcast.
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When Might You Use Heparin in the NeuroICU for a Stroke Patient?

December 2, 2020
Heparin in stroke remains controversial. Understanding the history and data and essential to mastering stroke care.
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Are the NNT and NNH for tPA Useful or Misleading in Acute Stroke Care?

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Stroke treatment data are hard to interpret and can be misleading. A lot of misinformation has made its way into the literature and has confounded acute stroke care. Understanding NNT and NNH can help clinicians understand risks and benefits in a meaningful way.
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Sep 7

Why Is the Extended Window Controversial and What Happened With the FDA?

Haemin Go posted on 9/7/2021

Moderator: William A. Knight IV, MD, FACEP, FNCS
Other Participants: Stacie L. Demel, DO, PhD

The ECASS 3 trial was an RCT of IV-rtPA in the window of 3-4.5 hrs after onset of stroke symptoms. It was conducted in Europe. The European regulatory bodies have endorsed tPA for that window, but the FDA has not. Listen to two national experts in stroke discuss the trial and the meaning of the endorsement or lack thereof. This podcast is a must for acute stroke practitioners!

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2 comments on article "Why Is the Extended Window Controversial and What Happened With the FDA?"

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Ken Milne

I watched the video on ECASS-III and you mentioned the controversy in this time window. However, there was no mention of Alper et al reanalysis in the BMJ_EBM that questioned the results? Can you comment? https://ebm.bmj.com/content/25/5/168


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Ken Milne

Here was some of our feedback on Alper et al https://ebm.bmj.com/content/early/2020/08/10/bmjebm-2020-111517
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