Does tranexamic acid improve recovery after spontaneous intracerebral haemorrhage? This 2018 appraisal of TICH-2 examines death and dependence, haematoma expansion and the uncertainty around the results. It explores why a possible effect on bleeding does not necessarily establish a meaningful improvement in patients’ longer-term outcomes.
JC: TICH TICH BOOM? TXA in ICH. St Emlyn’s Read More
This 2017 introduction explains tetanus, immunisation history and the assessment of wounds in the emergency department. It also discusses recognising clinical tetanus, but explicitly flags that UK management guidance has changed and directs readers to a later update.
Who gets a Tetanus? You get a Tetanus! Read More
A sceptical 2017 appraisal of a systematic review of intravenous thrombolysis for acute stroke. The post examines functional outcomes, bleeding and mortality, showing how interpretation of benefits and harms fuels disagreement; it presents the author’s historical critique rather than current treatment guidance.
JC: Kicking against the prick: Systematic Review of stroke thrombolysis Read More
Could platelet transfusion worsen outcomes after spontaneous intracerebral haemorrhage in patients taking antiplatelet drugs? This 2016 appraisal examines the PATCH trial’s unexpected findings, functional outcomes and limitations, asking why a biologically plausible treatment might fail to help the patients it was intended to benefit.
JC: Platelets for Intracranial Haemorrhage. St.Emlyn’s Read More
A 2014 appraisal of MR CLEAN, an early positive trial of intra-arterial treatment for selected patients with acute ischaemic stroke. Simon Carley examines imaging-based selection, pragmatic treatment choices and functional outcomes, while asking how confidently one trial could support wider adoption at the time.
JC: Intra-arterial treatment for Stroke Read More
Why can acute dystonia be mistaken for anaphylaxis, anxiety or neurological disease? This 2014 clinical review explores varied presentations, medication-related causes and diagnostic anchoring, alongside treatment considerations and the importance of reconsidering the diagnosis when the picture does not fit.
Dystonia in the Emergency Department. St Emlyn’s Read More
A 2013 invitation to scrutinise proposals for faster access to stroke thrombolysis. The post links competing discussions about the evidence and asks how assumptions about benefit should inform investment in prehospital pathways and hospital processes.
JC: Time is brain…., calling #FOAMagitators. St.Emlyn’s Read More
How should the early risks of stroke thrombolysis be weighed against later functional outcomes? This 2012 journal club debates IST-3, contrasting early mortality and bleeding with six-month survival and independence, and examining how the trial’s results are presented and interpreted.
JC: Thrombolysis in Acute Stroke – IST3 Read More
