Neuro Resus

This podcast episode features a conversation between Dr Oli Flower and his AI co-host, Simon (ChatGPT 4o), focusing on vasospasm and delayed cerebral ischemia (DCI) in aneurysmal subarachnoid haemorrhage (aSAH). The discussion covers: The distinction between radiological vasospasm (imaging finding) and DCI (clinical syndrome). The evolution of understanding DCI’s multifactorial causes, beyond just vasospasm. Evidence and controversies around ICU management, including blood pressure targets, nimodipine use, and the role of other interventions. Screening and monitoring strategies: transcranial Doppler, CTA, CTP, and the limitations of each. Post-management assessment, therapeutic hypertension, and the emerging role of milrinone. The importance of multimodal monitoring and the future potential of AI and global data sharing. The episode closes with a lighthearted off-topic discussion about casting for the new Naked Gun movie. The conversation is rich in clinical nuance, highlights current evidence gaps, and emphasises the need for individualised patient care and ongoing research.

Catherine Bell takes us through how to troubleshoot problems commonly encountered when looking after patients who have an external ventricular drain (EVD) in situ. Issues with using brain tissue oxygen monitors are also discussed. A highly practical session aimed at bedside clinicians. This presentation was delivered by Catherine Bell at CODA2022. Want more content about EVD? Visit neuroresus.com or subscribe to be notified of new podcast releases via email. To express your interest in attending the 2024 Neuroresus live course, click here.   

Angiographic vasospasm and more accurately, delayed cerebral ischemia, continue to contribute to morbidity and mortality in patients with aneurysmal subarachnoid hemorrhage (SAH). It is known that angiographic vasospasm is common after SAH, occurring in two-thirds of patients. This presentation was delivered by Rob Loch MacDonald at CODA2022. Want more content about aSAH? Visit neuroresus.com or subscribe to be notified of new podcast releases via email. To express your interest in attending the 2024 Neuroresus live course, click here. 

Lizzy suffered a substantial aneurysmal subarachnoid haemorrhage that left her critically unwell, requiring a long stay in intensive care recovering from the consequences and complications of this devastating form of stroke. Now a couple of years after her haemorrhage, Lizzy has come so far. She and her husband Gordon describe their experiences, right from the day it all began and through those tumultuous first few weeks, to where she is today. This open and honest account gives us all invaluable insight into what it’s like to go through the subarachnoid haemorrhage journey from a patient and family’s perspective, hopefully helping us empathise more and deliver better patient-centred care. This podcast was recorded at the Brain Symposium which took place in March 2023. For more talks and content like this, visit neuroresus.com or subscribe to be notified of new podcast releases via email. To express your interest in attending the 2024 Neuroresus live course, click here. 

Andrew Udy talks about the ongoing BONANZA Trial which is assessing whether an algorithm that incorporates both ICP and brain tissue oxygen (PbTO2) can improve outcomes after traumatic brain injury (TBI). Like with all monitoring, how the PbTO2 is interpreted and managed is critical and the devil is in the detail! More on BONANZA here More on BOOST3 here This presentation was delivered by Andrew Udy at CODA2022. Want more content about The Bonanza Trial? Visit neuroresus.com or subscribe to be notified of new podcast releases via email. To express your interest in attending the 2024 Neuroresus live course, click here. 

Historically, when it came to brain injury, ketamine had a bad rap. Much of that dogma was dispelled in the last 20 years, and ketamine is now frequently used as an induction agent in acute brain injury, especially traumatic brain injury, partially due to the favorable effects on haemodynamics.  However a new application of ketamine is now being explored - whether ketamine may be able to reduce secondary brain injury. In this talk Toby Jeffcote initially takes us through all the sedatives currently used in brain injury and the evidence to support their use. He then covers the history of ketamine use and the background to new research in use as a therapeutic agent. This podcast was recorded at the Brain Symposium which took place in March 2023. For more talks and content like this, visit neuroresus.com or subscribe to be notified of new podcast releases via email. To express your interest in attending the 2024 Neuroresus live course, click here. 

Cortical spreading depolarization (CSD) is a spreading loss of ion homeostasis, altered vascular response, change in synaptic architecture, and subsequent depression in electrical activity following an inciting neurological injury. This presentation was delivered by Toby Jeffcote at CODA2022. Want more content about CSD? Visit neuroresus.com or subscribe to be notified of new podcast releases via email. To express your interest in attending the 2024 Neuroresus live course, click here. 

Andrew Chow vs Andrew Udy  This debate was set up to discuss the issues with categorising traumatic brain injury (TBI). The current system using GCS to divide patients into mild, moderate and severe has been criticised in recent times, with calls for a more nuanced approach. The debate was a just bit of fun but does highlight the key issues. Chowie didn’t get to choose which side to argue for :) Andrew Chow, Intensivist with a neurosurgical background, argues that the current categorisation system for TBI works, and makes sense! He tackles us through the history of this system, and why it’s important to differentiate different types of TBI. The arguments in favour of this categorisation include the consistency and benefits of a universal language, the implications for triage and management, and the fact that this system has been endorsed by all major organisations. Andrew Udy then argues that this classification is fundamentally flawed. He discusses the issues with the Glasgow Coma Scale, and therefore the follow-on issues in TBI classification, including all the confounders to the GCS, the issues with timing of the score as well as GCS not taking baseline function or specifics subtypes of TBI into account. He makes the argument that biomarkers may better categorise the diffuse entity we call TBI. This podcast was recorded at the Brain Symposium which took place in March 2023. For more talks and content like this, visit neuroresus.com or subscribe to be notified of new podcast releases via email. To express your interest in attending the 2024 Neuroresus live course, click here. 

Dr Nick Little is an experienced Neurosurgeon who's looked after patients with traumatic brain injury for his whole career. Here he discusses the difficulties of prognostication following traumatic brain injury (TBI).  This podcast was recorded at the Brain Symposium which took place in March 2023. For more talks and content like this, visit neuroresus.com or subscribe to be notified of new podcast releases via email. To express your interest in attending the 2024 Neuroresus live course, click here. 

Tania Farrar is a neurologist and epileptologist with expertise in continuous EEG (cEEG) and status epilepticus (SE). This talk covers what a seizure is, what status is, including focal and generalised status epilepticus. This podcast was recorded at the Brain Symposium which took place in March 2023. For more talks and content like this, visit neuroresus.com or subscribe to be notified of new podcast releases via email. To express your interest in attending the 2024 Neuroresus live course, click here.