The 18th Annual Stroke & Cerebrovascular Disease Review is coming to The Ritz-Carlton Amelia Island this October 14-17. This year’s curriculum map: 🧠 Large vessel occlusion dynamics — from MeVO/M2 to basilar 💊 ICH reversal timing — when the 4-hour clock matters 🔬 CREST-2 keynote — the investigators, in person @Demaerschalk @ThomasBrott ⚡ Status epilepticus /stroke mimics— beyond first-line, Rapid EEG 🫀 Occult AF detection & management 🏥 Prehospital stroke systems of care 🔄 Minimally invasive ICH surgery — ARCH trial update 🧬 Cerebral amyloid angiopathy — emerging therapeutics 🏥 Stroke Economics and Social Determinants of Health (SDOH) Jointly accredited: CME / Pharmacy CE / Nursing CE. Built for the whole team — neurologists, neurosurgeons, APPs, nurses, pharmacists. Registration details below. 👇🏽 Save the dates: October 14-17, 2026. ce.mayo.edu/stroke2026 @tamrar1 @RabihTawkMD @wchrisfox @ThienHuynh15 #StrokeAmeliaIsland #MayoCPD #Stroke #Neurology #CME #NeuroCriticalCare

@higgsfield_ai @OpenAI dot

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👏 @Google @STRXLabs @gisellecoelhomd Expand healthcare triage at scale

🧠 Less than 3 weeks to the 18th Annual Stroke & Cerebrovascular Disease Review at Amelia Island, Oct 14–17 | Live + Livestream Lots of stroke and Cerebrovascular topics and trials to review ! A few highlights: → Dr George Harston: Can AI Improve Health Equity in Stroke Care at Global Scale? → ARCH Trial update @berejah → MIND Trial results @babaksjahromi → Hands-on skills fair In person or livestream. Register: ce.mayo.edu/neurology-and-ne…

Nimodipine in the catheter flush cuts periprocedural vasospasm by more than half
 German Stroke Registry–ET, 25 centers, n = 16,583 — the largest look yet at a habit that varies center to center. Nimodipine-containing flush used in 7,548 (45.5%). •Vasospasm: IPTW-adjusted 1.8% vs 4.8%; OR 0.38 (95% CI 0.30–0.47), P<0.001 •90-day mRS 0–1: OR 1.23 (1.13–1.34); mRS 0–2: OR 1.16 (1.08–1.25), both P<0.001 Caveat: registry, not randomized — flush composition correlates with center culture, and IPTW can't fix unmeasured operator skill. But the cost of adopting it is low. Reference: 📄 J NeuroInterventional Surg, 2026 Sep 11 · DOI: 10.1136/jnis-2026-025972 · PMID 42728086 pubmed.ncbi.nlm.nih.gov/4272…

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🧠 Is automated CSF exchange poised to replace standard passive drainage in neurocritical care? A meta-analysis synthesizing data from 834 patients across 7 studies compares Active Cerebrospinal Fluid (ACE) exchange—including neuroendoscopic lavage and IRRAflow systems—against conventional External Ventricular Drainage (EVD) in intraventricular hemorrhage (IVH) and subarachnoid hemorrhage (SAH). Key Findings: 🩸 2.7x Higher Hematoma Clearance: ACE significantly accelerated blood clot resolution compared to EVD (OR 2.72 [95% CI, 1.22–6.08], p=0.015). 💪 66% Better Functional Recovery: Patients treated with ACE achieved higher odds of favorable neurological outcomes (mRS score <= 3) (OR 1.66 [95% CI, 1.12–2.48], p=0.012). 🛡️ 78% Lower Infection Rate: Continuous active irrigation and drainage markedly decreased post-procedural infections (OR 0.22 [95% CI, 0.12–0.42], p<0.001). 🔌 78% Lower Shunt Dependency: Rapid blood evacuation significantly reduced chronic hydrocephalus and permanent shunt placement (OR 0.22 [95% CI, 0.10–0.50], p<0.001). ⚖️ Comparable Safety Profile: No statistically significant differences were observed between ACE and EVD regarding mortality (p=0.716), rebleeding risk (p=0.257), or length of ICU stay (p=0.447). Subgroup Highlights: • Neuroendoscopic lavage demonstrated the highest efficacy for hematoma clearance (OR 3.70, p=0.010). • IRRAflow systems provided superior infection reduction (OR 0.24, p<0.001) [6]. • Younger patients (<60 years) derived the greatest benefits in clot clearance and functional recovery. 💡 Bottom Line: Active CSF exchange represents a promising advance over passive EVD, accelerating clot evacuation while reducing infection and permanent shunt dependency. What are your thoughts on adopting automated active irrigation in the neuro-ICU? Let us know your perspective below! 👇 Reference: Bahadori AR, Röblom A, Niemelä M, et al. Active Cerebrospinal Fluid Exchange Versus External Ventricular Drainage in IVH and SAH: A Meta-Analysis. Stroke Vasc Interv Neurol. 2026. ahajournals.org/doi/suppl/10… @berejah @babaksjahromi @RabihTawkMD

“Time is Brain” for SAH 🩸 too! Does the aSAH clock start at the door, or at the first headache? A 7-center cohort from China says the prehospital window is the outcome lever we keep undercounting. 726 adults with aneurysmal SAH. Rapid transfer (to an endovascular-capable hospital in 8 hours or less) vs delayed (after 8 hours): 🚑 386 made it in 8 hours (53%). 340 did not. 🧠 6-month mRS >2: 8% vs 23% (adjusted OR 5.3) 💔 12-month death: 4.9% vs 8.8% (adjusted OR 2.6) ⚠️ Delayed transfer also tracked with more herniation, hydrocephalus, ischemic stroke, and rebleeding Only about half of this network hit the 8-hour window. If your region still treats aSAH transfer as get-there-sometime-today, this is the number to take to the transfer committee. What cutoff does your system actually hit? Drop your comments below 👇🏽 Reference: Mi S, Xiao ZK, Wang B, Duan Y, Liu A. The impact of rapid transfer on the prognosis of aneurysmal subarachnoid hemorrhage: a multicenter cohort study. World Neurosurg. 2026. doi:10.1016/j.wneu.2026.125269 doi.org/10.1016/j.wneu.2026.…

🚨 Why does blood pressure spike during an ischemic stroke, and what is the optimal BP during thrombectomy? 🧠 When a large blood vessel is blocked, the nervous system triggers heightened sympathetic activation to preserve blood flow to the brain. Clinically, this protective spike is known as the acute hypertensive response, acting as a variant of Cushing's reflex. Since this elevated BP is a natural mechanism to push blood past the clot, should we maintain this high, individualized baseline during mechanical thrombectomy surgery? 🏥 The DETERMINE trial [1] tested this exact hypothesis by comparing two management strategies: 🔹 Individualized BP: Keeping mean arterial pressure within 10% of the patient's elevated, natural baseline. 🔹 Standard BP: Targeting a flat systolic BP of 140-180 mmHg. The Results: ❌ No clinical benefit. A favorable 90-day functional outcome was seen in 44.2% of the individualized group vs 48.8% of the standard group . ⚠️ Safety, including mortality and symptomatic brain bleeds, was virtually identical. Why did the physiologic approach fail? Because managing the body's acute hemodynamic instability is incredibly difficult. Patients in the individualized group only spent a median of 58.1% of the procedure in their precise target zone. The Takeaway: While supporting the brain's acute hypertensive response makes physiologic sense [2], trying to maintain those exact individualized targets during surgery is too complex right now. Standard BP targets remain the most practical strategy until we develop real-time, dynamic autoregulation monitoring. Read the full study and physiology review below: 👇🏽 1. Mäıer B, Gory B, Chabanne R, et al. Individualized vs Standard Blood Pressure Control During Thrombectomy for Ischemic Stroke: The DETERMINE Randomized Clinical Trial. Neurology. 2026;107:e218420. doi:10.1212/WNL.0000000000218420 doi.org/10.1212/WNL.00000000… 2. Qureshi A. Acute Hypertensive Response in Patients With Stroke: Pathophysiology and Management. Circulation. ahajournals.org/doi/10.1161/…