Introduction To Stroke

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  • Опубліковано 1 лип 2018
  • Please note that this video was made in 2018, so the acute management of stroke has changed somewhat. While the principles still hold, we do not discuss the indications for thrombectomy. Please refer to my most recent videos for that ( • Clinical Consult: Remo... and • Clinical Consult: Prev... ).
    00:56 Objectives
    00:52 Vascular anatomy and syndromes
    ACUTE ISCHEMIC STROKE
    07:59 Case of a confused man
    11:35 National Institutes of Health Stroke Scale
    14:21 Reading a head CT
    17:13 Primary goal of acute ischemic stroke management
    17:46 Intravenous tissue plasminogen activator
    19:40 Mechanical thrombectomy
    21:05 Time is brain!
    23:30 Preventing secondary injury and preventing stroke recurrence
    25:28 Ischemic stroke workup
    26:43 Classification and pathologies
    33:24 Ischemic stroke risk by mechanism
    38:49 Prevention regimen
    40:06 Transient ischemic attack
    41:47 Interlude
    ACUTE CEREBRAL HEMORRHAGE
    43:03 Case of a man with a headache
    44:15 Acute management
    46:36 Classification and mechanisms
    48:02 Diagnostic workup
    51:14 Hemorrhagic stroke risk by mechanism
    51:41 Subarachnoid hemorrhage
    54:10 Management of acute subarachnoid hemorrhage
    56:05 SUMMARY
    Slides:
    drive.google.com/file/d/1OCez...
    Developed, Produced and Narrated by:
    Igor Rybinnik MD
    Assistant Professor of Neurology
    Neurology Clerkship Director
    Rutgers Robert Wood Johnson Medical School
    Appropriate for:
    MS2-4 learner level
    Disclaimer: Please note that this material was simplified for educational purposes. For patient management, please review your clinical society's guidelines and engage expert consultation when appropriate. Also, the opinions expressed in this talk do not necessarily reflect those of Rutgers Robert Wood Johnson Medical school or Rutgers University as a whole.

КОМЕНТАРІ • 90

  • @meto2854
    @meto2854 Рік тому +28

    A neuro resident in my 1st year here. Can’t tell you how grateful I am for these vids! PLEASE PLEASE PLEASE make more! Thanks :D

    • @theneurophile
      @theneurophile  Рік тому +11

      Thank you. I just need to find some free time to make more of these.

    • @meto2854
      @meto2854 Рік тому +6

      @@theneurophile I think a good NIHSS tutorial would be essential. Especially how to take the NIHSS when it comes aphasic or comatose/somnolent patients. And how to score it accordingly.

  • @lindalee8793
    @lindalee8793 3 роки тому +25

    I am binge watching your channel.... and not simultaneously with netflix

  • @sanjnapatel2568
    @sanjnapatel2568 4 місяці тому +3

    you gave a lecture at my school last year and it was so good i am revisiting this for my clinical rotations! Please never stop teaching preclinical students

  • @SpeedyMedical
    @SpeedyMedical 2 роки тому +23

    As an educator ,I can understand the amount of hardwork that goes behind making these videos, good job doctor and super easy flow of information n understanding

  • @the-neurosurgeon
    @the-neurosurgeon 2 роки тому +5

    I am a neurosurgeon and your lectures make the concepts crystal clear.

  • @balla03og
    @balla03og Рік тому +3

    Your sense of humor is gold... we're lucky to have someone like you helping us in our personal medical endeavors.
    Much gratitude :)

  • @thecuriousboy8255
    @thecuriousboy8255 Рік тому +2

    Can't thank you enough. You are a great teacher.
    From Kerala, India.

  • @tresconium1
    @tresconium1 3 роки тому +10

    I am neurology resident from Mumbai, India. I must say you created amazing content. Just loved your presentations! Can't thank you enough!

  • @bnfgh123
    @bnfgh123 Рік тому +5

    This is some ridiculously good content. I'm hoping to start my neurology residency next year, and these videos will be great to start preparing for it.

  • @csingilingemo
    @csingilingemo 3 роки тому +7

    Dear dr. Rybinnik! These videos are extremely useful for radiologists too! Thank you,thank you so much!

  • @trevorcline903
    @trevorcline903 Рік тому +1

    Thank you Dr. Rybinnik I love your talks and recommend them to all my colleagues and students. You have a big fan base in Southern California!

    • @theneurophile
      @theneurophile  Рік тому

      Thanks! Now I need to somehow find more hours in the day to make more of these.

  • @xDomglmao
    @xDomglmao 4 роки тому +11

    Very well done and pleasant voice! Thank you very much for this great lecture! First time I directly subscribed to a channel after less than 5 minutes

  • @carinas1180
    @carinas1180 Рік тому +1

    2nd year of neurology resident here...your explanation is so detail...Good Job doc! pls make more videos. :)

  • @atikahkhaulah311
    @atikahkhaulah311 3 роки тому +6

    for no reason the prof is definately read my mind....

  • @jaelee1375
    @jaelee1375 2 роки тому +8

    Thank you for the lecture, just started neurology rotation and having material presented like this has been amazing!

  • @vladislavatimcenko4856
    @vladislavatimcenko4856 3 роки тому +3

    Thank you for this presentation! It's very well structured and understandable, makes the topic seem less scary

  • @AkashMishra23
    @AkashMishra23 2 роки тому +1

    Absolutely love your sense of humor

  • @K32Whit
    @K32Whit 3 роки тому +2

    Well done and great intro to stroke neurology.

  • @samuelaliu5088
    @samuelaliu5088 11 місяців тому +1

    You’re a blessing to me and many. Thank you. And keep up the good work

  • @user-pk3ci4rt7x
    @user-pk3ci4rt7x Місяць тому +1

    Very conclusive. Thanks ❤

  • @rebecakinomotomartinez5446
    @rebecakinomotomartinez5446 Рік тому +1

    Thank you!!
    You have made my looooong study hours easier!!

  • @camilomunevar4471
    @camilomunevar4471 2 роки тому +1

    Nice and clear lecture, thank you!

  • @caiyu538
    @caiyu538 2 роки тому +1

    Great series.

  • @kingarthur1469
    @kingarthur1469 2 роки тому +1

    Thank you sir...really well explained and made concepts easy.

  • @jbbrockman4560
    @jbbrockman4560 8 місяців тому +1

    Fantastic presentation

  • @dr.eseosaighodaromdphd8662
    @dr.eseosaighodaromdphd8662 3 роки тому +1

    I love your videos! Thx for uploading!

  • @p.prague5662
    @p.prague5662 3 роки тому +1

    This is very helpful lecture! Thank you so much 😊

  • @mukeshrana4213
    @mukeshrana4213 Рік тому +1

    Thank you for the video.
    awesome lecture…

  • @brtalin28
    @brtalin28 3 роки тому +4

    This is what i call a high quality presentation! Well done!

  • @zeljkacuk4498
    @zeljkacuk4498 3 роки тому +1

    thank you so much for this video!

  • @gagandeep-8916
    @gagandeep-8916 7 місяців тому +1

    At 44.08 it is right Thalamic haemorrhage and not right thalamic. I am loving this lecture series.

  • @hassanaboyounis6638
    @hassanaboyounis6638 Рік тому +1

    Good job, I’m speechless

  • @monirzaman1202
    @monirzaman1202 2 роки тому +1

    Just awesome.

  • @SemperCuriosus_
    @SemperCuriosus_ 4 роки тому +21

    If all lectures in med school were like this I'd have actually gone to lecture.

    • @theneurophile
      @theneurophile  4 роки тому +5

      That's a high praise, indeed. I was in your place as well, so I'm trying to fix it (at least in Neurology).

  • @Chiboza
    @Chiboza 3 роки тому +2

    Thank you for this. On October 2020 I've experienced medulla stroke (Wallenberg's Syndrome) and it wasn't even half as interesting as this video!

    • @theneurophile
      @theneurophile  3 роки тому +1

      I'm sorry to hear that. I hope you have recovered.

    • @Chiboza
      @Chiboza 3 роки тому

      @@theneurophile Thank you, it seems I'm back to 100% me. As long as I don't get another vertebral dissection - I should be fine :) Also, thanks for covering both topics - I'm not a medical student, but really got interested in both stroke and dissections and you explained both so well! Cheers!

  • @kitsune._.._.
    @kitsune._.._. 10 місяців тому +1

    thank you so much!

  • @luisfernandomonroyaraux8391
    @luisfernandomonroyaraux8391 3 роки тому

    Muchas gracias, lo difícil lo haces fácil!!!! gracias Doctor.

  • @doctormsigwa8578
    @doctormsigwa8578 4 роки тому +1

    Thank you! 👍

  • @MBBSZaraHutKay
    @MBBSZaraHutKay 2 роки тому +2

    Love from Depths of My Heart Brain and Soul

  • @youngmedlion8631
    @youngmedlion8631 2 роки тому +1

    Perfection!

  • @hassabomohamed9833
    @hassabomohamed9833 3 роки тому +1

    Thanks a lot

  • @SARY1915
    @SARY1915 2 роки тому +1

    ER nurse here, thanks!

  • @michaelcorlette7257
    @michaelcorlette7257 Рік тому +1

    The SOOOO important to know

  • @setokachhuwa8691
    @setokachhuwa8691 2 роки тому +1

    Awesome!!!!!

  • @ahmedidowu2991
    @ahmedidowu2991 3 роки тому

    Thanks for the wonderful piece.it will be great if there is an update review of the lecture on yearly basis at least. Please, is there any lecture on the CT/MRI brain and spine neuroanatomy?

    • @theneurophile
      @theneurophile  3 роки тому

      Check the more recent videos on the channel. The stroke cases have more updated information. There is a separate spine disorders talk and Brain Imaging crash course

  • @kaazooyii
    @kaazooyii Рік тому +1

    Love it

  • @ansarulrana3566
    @ansarulrana3566 5 місяців тому

    The purpose of this video is not to educate you rather to give you the Impression that the video maker has lot of knowledge, dam it.

  • @abeselomtedla1652
    @abeselomtedla1652 10 місяців тому +1

    Outstanding lectures 👌 👏 🙌.
    Do you have lectures on subarachnoid hemorrhage..if not please do one...please let me know 🙏

  • @saiduabubakar286
    @saiduabubakar286 2 роки тому

    Hello Dr Rybinnik
    Thank you so much for your excellent videos. As an educator myself, I really appreciate the effort and time required to make such high quality work.
    Two questions, if you do not mind. Are you planning to cover, anytime soon, brainstem anatomy/localisation/the rule of 4s? It will be very interesting to see your take on this.
    Secondly, what software do you use to make these presentations? Is it Powerpoint/Keynote only or a combination of that and others?
    Once again, much obliged.

    • @theneurophile
      @theneurophile  2 роки тому +3

      Thank you for your kind words. I am planning a giant clinical neuroanatomy video. I am just collecting enough patient videos to cover all my points. I am using PowerPoint for animations but graphics are edited in Adobe Creative Suite.

  • @Jlechnerbecker
    @Jlechnerbecker Рік тому

    Your delivery of difficult info is incredible (especially for a non medical individual such as myself). Hopefully I can get some help here…How does bacterial meningitis from GBS cause ischemic stroke in a 6 day old baby? Asking in reference to my now 18 month old daughter, thanks

    • @theneurophile
      @theneurophile  Рік тому +1

      Unfortunately I do not have as much experience with pediatric patients. But, meningitis is known to cause strokes in adults. Thankfully it is a rare event.

  • @prestonm.5286
    @prestonm.5286 Рік тому +2

    Time is tissue!

  • @jasperprem8793
    @jasperprem8793 2 роки тому

    Dear Dr, I'm a cardiovascular Invasive Specialist, this lecture was extremely useful for me,I wish to get a reference book for stroke management and aneurysm. Kindly guide me..

    • @theneurophile
      @theneurophile  2 роки тому +1

      For the most recent management, I would refer you to the American Stroke/American Heart Association Guidelines -- professional.heart.org/en/guidelines-and-statements. Uptodate.com is also a good resource, and easier to read. With respect to management, books are generally outdated by the time they are printed.

  • @khaireidea2224
    @khaireidea2224 9 місяців тому

    Thank you so much dr❤
    Could we the slides please?

    • @theneurophile
      @theneurophile  9 місяців тому

      Of course. The link is in the video description.

  • @delianebunu3612
    @delianebunu3612 4 місяці тому +1

    What are other causes of thunderclap headache?

    • @theneurophile
      @theneurophile  4 місяці тому

      Excellent question. For the answer to that question, please watch our thunderclap headache video that was just posted.

    • @delianebunu3612
      @delianebunu3612 4 місяці тому +1

      Perfect, thank you for your content on this channel. You really make a difference in this world!

  • @talalalotaibi3626
    @talalalotaibi3626 2 роки тому +1

    16:05 the left ct brain is not normal, it demonstrates a blurring of insular G-W junction as loss of ribbon sign? As hyperacute ischemic insult

    • @theneurophile
      @theneurophile  2 роки тому

      It's actually normal, just doesn't project well through UA-cam

  • @dominicdigginnursingstuden7833

    I was told TIAs don't always show up on imaging do we go by clinical findings along with NIHSS and history?

    • @dominicdigginnursingstuden7833
      @dominicdigginnursingstuden7833 Рік тому

      Also doctor is there a way to get copy's of the PowerPoint slides I want to print and study them before neurology rotations

    • @theneurophile
      @theneurophile  Рік тому

      It is true that there is such a thing as MRI-negative stroke (patients with persisting stroke symptoms that have negative imaging). However, most transient neurological symptoms are NOT caused by blood flow problems (basically not TIAs). The term "TIA" is so frequently misapplied that as a stroke Neurologist, I now generally forbid the use of the term "TIA" to anyone but senior neurology residents and above. Negative stroke work-up (including MRI) in a patient with transient deficits effectively makes cerebrovascular etiology (stroke or TIA) much less likely.

    • @theneurophile
      @theneurophile  Рік тому

      @@dominicdigginnursingstuden7833 I linked the slides in the description.

  • @dorothy-myrasackey6511
    @dorothy-myrasackey6511 Рік тому +1

    Got it

  • @brainman709
    @brainman709 3 роки тому

    Could you provide time stamps?

    • @theneurophile
      @theneurophile  3 роки тому +1

      Time stamps were added as requested.

  • @claychandler3468
    @claychandler3468 2 місяці тому

    I had a stroke once , i never removed from. That game of golf😂.

  • @cpchehaibar
    @cpchehaibar 2 роки тому

    I really hope that, if need arises, I'm not taken care of by any neurologist who watched netflix while cramming.

    • @theneurophile
      @theneurophile  2 роки тому +1

      I highly doubt it. By far the majority of doctor training is not done through lectures. That is the reason doctors complete years of residency to become proficient in their craft.

  • @ahmedthamir9531
    @ahmedthamir9531 2 роки тому +1

    Other causes of thunderclap headache ? 🤔
    an actual thunderclap ..🙋😂.
    no need to clap thank you .

  • @Sandsack2311
    @Sandsack2311 2 роки тому +1

    There is actually a randomized controlled trial that proves parachutes do not lower mortality after jumping: www.bmj.com/content/363/bmj.k5094

  • @designmaster5074
    @designmaster5074 Рік тому

    thank you so much!