Your Brain Health’s Post

VOMS is great for getting baseline symptom levels and can be used as a recheck for progress, along with other measures such as Buffalo Concussion Treadmill Test (vitals response and not just symptoms) as well as dual task assessment. What are your favorites for concussion assessment?

The Head Impulse Test forms part of an assessment that may be helpful in diagnosing unilateral peripheral vestibular deficits. The test assesses the Vestibular-Ocular reflex which allows for clear vision and gaze fixation when the head moves. The test assesses your ability to keep your eyes focused and steady as your head moves (Treleaven et al. 2023). An abnormal response is when the patients eyes are dragged off the target by the turning of the head, followed by a corrective saccade back to the target after the turning of head.

60 y/o patient with very frequent premature ventricular complexes (PVC) - 40 to 50%! Initial ECG suggested right ventricular exit (QS complex in V1). Activation mapping in the RV with earliest activation (-50 ms) septally about 1 cm underneath HIS region, careful energy delivery and intermittent junctional rhythm during ablation. Multiple ablation points up to 7 mm distance to sharp HIS signal with PVC suppression for approx. 1 minute, then recurrence of PVC. Due to slightly changed exit (small R wave in V1) transseptal puncture and left septal mapping. Here, earliest activation (-54 ms) 7 mm away from the best right-sided ablation point, 9 mm from HIS. Immediate PVC suppression, no recurrence. No junctional beats during ablation. Great support as always by our fantastic cath lab team, Christoph Keil, Johannes Anderl, Alexander Neumayer

As you can see the intra-aortic balloon counter pulsation under the fluoroscopy.🫀 Fluoroscopic visualization of intra-aortic balloon catheter inflation in descending aorta, optimizing hemodynamic support."........

💡 What makes Closed Loop Stimulation (CLS) a better option for delaying atrial high-rate episodes (#AHRE) in patients with sinus node dysfunctions (#SND)? 👨⚕️ According to Dr. Botto, the #CLS sensor’s physiological regulation of heartbeats provides a more natural and efficient way to manage AHRE than traditional dual-chamber (DDDR) pacemakers. The B3 study shows BIOTRONIK’s CLS sensor reduces the risk of AHRE, stroke, or TIA by 16%: https://ow.ly/KNh350SM7BQ #SwitchToCLS #HealthcareAdvancement #ClosedLoopStimulation

Gamma Knife - The Technology 👉 thousands of radiation beams are generated, about the thickness of a strand of hair. Individually, each radiation beam is too weak to damage the normal tissues it crosses on the way to the target. When focused precisely on that target? 👇 The beams intersect and the combined radiation is sufficient to treat the specific area. Because of its accuracy, the full dose of radiation can usually be delivered during a single session. State-of-the-art treatment, being delivered to a growing number of patients! 👏

How much fluid in the knee is normal and when do you call an effusion? Knee flexion plays a big role in suprapatellar pouch effusion size. A slight flex of the knee is ideal with fluid still visible deep to the quadriceps tendon. If in this setting, we see fluid bulging out medial and lateral around the quadriceps tendon in transverse plane we would consider this an effusion. As you flex the knee, the quadriceps will tighten further over the recess and push more fluid medial and lateral to the tendon. It's subjective, a small amount of physiological fluid is normal, but when the joint is distended or bulges medially and/or laterally, then we would call this an effusion.

A valuable tip for challanging access in radial coronary angiography: exersize patience 👌

CPAP is a type of non-invasive ventilation... What does it stand for? A) Cardiac Position Atrial Pressure B ) Continuous Position Airway Pressure C) Continuous Position Anatomical Pressure D) Continuous Positive Airway Pressure Read carefully and put your answer below. 👇🏻👇🏻👇🏻

VIVO identifies anatomic locations pre-procedurally, improving procedural planning and saving time. A 60-year-old male presented for a PVC ablation with 20% burden. VIVO quickly localized the PVC to the LV summit. After a quick map of the RV, only producing late signals, the physician mapped the region indicated by VIVO via a retrograde approach and received signals 27 ms pre-QRS. The PVC was terminated via RF and was non-inducible following V-stim and 30-minute waiting period. Total procedure time was less than 1.5 hours!