I've made a number of infographics since joining Twitter and many are buried in my timeline. I figured I'd start a thread of all the infographics I've made over the years so they are more readily available!.👇 🖼️.

In your practice, what clinical scenarios can be considered for tPA administration outside of the 4.5-hour window?. #NCSPharmJC.

In conclusion: The EXPECTS trial showed tPA within 24h of LSW in posterior AIS led to improved functional outcomes at 90d w/o higher sICH rates. #NCSPharmJC.

The trial is strengthened by its exclusive enrollment of posterior circulation strokes and strict protocol, but may limited by its geographic region and exclusion of patients who had access to EVT and the fact that stroke severity in the trial was low. #NCSPharmJC

tPA treated patients had a higher proportion of functional independence compared to standard of care (89.6% vs 72.6%). sICH occurred at a similar rate between groups. #NCSPharmJC

234 patients were enrolled and groups were well matched. Strokes were overall fairly minor and the distribution of time periods was equal across groups. #NCSPharmJC

The primary outcome was functional independence at 90 days (mRS 0-1) and the secondary outcomes were the standard stroke trial outcomes, including safety analyses. #NCSPharmJC

EXPECTS was a PROBE enrolling patients with posterior symptoms between 4.5-24 hours of symptom onset. Patients were randomized to standard tPA dosing or placebo/standard of care. #NCSPharmJC

The EXPECTS trial sought to answer whether using an extended window in posterior strokes safe, and what the risks are. #NCSPharmJC

Several trials have looked at extended window interventions, but none have specifically evaluated posterior AIS. #NCSPharmJC

Posterior circulation strokes can lead to severe disability and can be challenging to identify, and thus interventions to treat posterior circulation strokes outside of the standard window are of great interest. #NCSPharmJC

Next up: Kayleigh Yaeger, PharmD, PGY2 CC from UPMC is presenting Alteplase for posterior circulation ischemic stroke at 4.5 to 24 hours – The EXPECTS Trial. #NCSPharmJC

@jaidyndejesus Do you feel as though the results of this study can be extrapolated to the TBI patient population seen at your institution?. #NCSPharmJC.

@jaidyndejesus In summary: In this single-center RCT, modafinil led to an increased proportion of patients with moderate to severe TBI with an increased level of consciousness in the acute recovery period. Thanks for presenting @jaidyndejesus!. #NCSPharmJC.

The authors concluded that modifinil led to a 22% higher proportion of patients experiencing an increase in consciousness, with notable limitations, and questions remain. @jaidyndejesus . #NCSPharmJC

The authors concluded that modifinil led to a 22% higher proportion of patients experiencing an increase in consciousness, with notable limitations, and questions remain. #NCSPharmJC

The authors found that increase in total GCS was higher in the modafinil group compared to placebo, but secondary outcomes were not significant. #NCSPharmJC

96 patients were enrolled, with good balance between groups. #NCSPharmJC

This small RCT sought to evaluate whether modafinil in TBI led to faster recovery of consciousness, comparing modafinil 200 mg daily for 7 days vs placebo. #NCSPharmJC

Multiple neurostimulants are currently used in practice, but there is relatively limited data for the use of any of them, other than amantadine in TBI. #NCSPharmJC

First up: Efficacy of Modafinil on Accelerating Consciousness in Traumatic Brain Injury, presented by Jaidyn De Jesus, PharmD, PGY2 at Brown RIH. #NCSPharmJC