Use of alteplase from 4.5 to 9 hours in patients with ischemic stroke but with salvageable brain on perfusion imaging was superior to placebo (aRR 1.44, 95%CI 1.01-2.06; NNT = 17). Symptomatic hemorrhage was more common in the alteplase group.
It was a big job for ALiEM to come up with the list of 52 landmark articles you need to know as an Emergency Physician. But it's an even bigger job to sit down and read them. In fact, most of us just won't be able to find the time to do it. Because they are so important to know, I wanted to make it easier to get the gist of these articles. So each Saturday in 2017, I briefly summarized one of these key articles. For your convenience, here are the links and excerpts for each of the 52 in 52 article summaries in one place. Enjoy. And please share this with a friend. Special thanks to Dr. Michelle Lin for allowing me to partner with ALiEM and use the combined logos.
The NEXUS criteria can be used to determine which patients do not need c-spine x-rays. Since this was published, we have shifted to predominantly CT imaging, which is more sensitive. Also, we have learned that NEXUS is not as sensitive in elderly patients.