American Heart Association

Monthly Archives: March 2020

ISC 2020 Session: “Contemporary Management of Unruptured Intracranial Aneurysms: What to Counsel Patients”

International Stroke Conference
February 19–21, 2020

Kat Dakay, DO

Deciding how to manage unruptured intracranial aneurysms is a common challenge in neuroendovascular surgery, as many of these aneurysms are incidentally found on imaging performed for other reasons. The classic dogma of the ISUIA study stratifies rupture risk based on size and location; however, this is an oversimplified picture. In this ISC session, the speakers discussed complex anatomical features, neuroimaging findings, and lifestyle counseling for patients with unruptured intracranial aneurysms.

Dr. Juhana Frösen discussed the influence of wall structure on rupture risk; the wall structure of aneurysms is very heterogenous. This may explain why some small aneurysms can rupture. Macrophages and inflammation can lead to aneurysm wall growth, which increases the stress on the aneurysm and can increase the risk of rupture. Future targets for drug research may include reducing inflammation and reducing wall growth.

ISC 2020 Session: “Widening the Lens of Telestroke: From the ED Across the Stroke Continuum”

International Stroke Conference
February 19–21, 2020

Session: “Widening the Lens of Telestroke: From the ED Across the Stroke Continuum,” Thursday, February 20, 2020

Jennifer Majersik, MD: Physician at the University of Utah – Expansion of Telestroke Networks
Matthew Koenig, MD: Physician at Queens Medical Center – Tele-ICU
Steven Cramer, MD: UCLA, University of California Irvine – Tele-rehabilitation
Christine Holmstedt, DO: Medical University of South Carolina – Outpatient Telestroke Follow-up

Stephanie Lyden, MD, BS

This talk provided multiple examples of varied practice settings that use telemedicine to provide patient care. The talk started with Dr. Jennifer Majersik discussing the Expansion of Telestroke Networks. She initially explained the process of consulting a neurologist via telestroke. This is often being utilized by community hospitals that do not have a local neurologist to consult. She explained that there are different levels of acuity (hyper-acute with telestroke vs acute with emergent teleneurology vs non-urgent with scheduled teleneurology) within teleneurology consults. She noted that with a telestroke consult, the main questions addressed include whether the patient is eligible for tPA or thrombectomy, both of which are time sensitive, and the goal of these consults is for them to be completed within 10-30 minutes.