Tim Amrhein, MD @TimAmrheinMD X Profile

Tim Amrhein, MD

@TimAmrheinMD

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Neuroradiologist. Duke University Medical Center. Director of Spine Intervention.

Durham, NC

Joined April 2015

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Tim Amrhein, MD

@TimAmrheinMD

1 year

Duke and Mayo team SIH collab in the running for 2024 @TheAJNR Journal Award!. Vote here: Efficacy of Epidural Blood Patching or Surgery in SIH: A Systematic Review and Evidence Map. @DukeRadiology @DukeNeurorad @MayoRadiology

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Tim Amrhein, MD

@TimAmrheinMD

3 years

PCCT's superior resolution and signal to noise ratio may improve sensitivity for detection of occult CVFs in patients with definitive SIH. Had another case just today where PCCT saved the day! @JAMANeuro.

AuntMinnie.com

@AuntMinnie

3 years

Photon-counting CT visualizes cerebrospinal fluid (CSF) venous fistula (CVF) better than traditional imaging approaches such as CT myelography or MRI, according to a report in @JAMANeuro led by Dr. Fides Schwartz of @DukeRadiology. #radiology

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Tim Amrhein, MD

@TimAmrheinMD

3 years

RT @AuntMinnie: Photon-counting CT visualizes cerebrospinal fluid (CSF) venous fistula (CVF) better than traditional imaging approaches suc….

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Tim Amrhein, MD

@TimAmrheinMD

3 years

DECT, PCCT? There's something here. this has been very helpful for a subset of our patients:.

jamanetwork.com

This case report describes the use of traditional computed tomography vs photon-counting computed tomography in evaluating the potential cause of spontaneous intracranial hypotension in a 56-year-old...

Peter Kranz

@PeterGKranz

3 years

Anyone else using DECT for CSF-venous fistula detection? What has been your experience?. @DukeRadiology #JessHouk @TimAmrheinMD #MikeMalinzak.

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Tim Amrhein, MD

@TimAmrheinMD

3 years

RT @HeadacheJournal: New Instagram post! . Popping the balloon: Abrupt onset of a spinal #CSFleak & SpontaneousInt….

instagram.com

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Tim Amrhein, MD

@TimAmrheinMD

4 years

RT @StanfordHAI: CALL FOR APPLICATIONS: The Junior Fellows Program at HAI is a prestigious program for early-career scholars who are seekin….

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Tim Amrhein, MD

@TimAmrheinMD

4 years

RT @The_ASSR: .@The_ASSR Research Grant application is open! Funding to advance the understanding, dianosis, & treatment of spine pathology….

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Tim Amrhein, MD

@TimAmrheinMD

4 years

RT @The_ASSR: @AshwaniGore received the ASSR research grant last year for identifying the primary pain generator in patients with axial fac….

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Tim Amrhein, MD

@TimAmrheinMD

4 years

RT @WouterSchievink: We ⁦@spinalCSFleak⁩ are looking forward to seeing you in October #SIH #CSFleak

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Tim Amrhein, MD

@TimAmrheinMD

4 years

RT @DukeRadiology: . still time to register!. The 2021 “Headache: The Highs & Lows of CSF Pressure Problems” virtual meeting, @DukeRadiol….

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Tim Amrhein, MD

@TimAmrheinMD

4 years

RT @DukeRadiology: The 2021 “Headache: The Highs & Lows of CSF Pressure Problems” virtual meeting, @DukeRadiology March 13-14, 2021. Onl….

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Tim Amrhein, MD

@TimAmrheinMD

4 years

SIS just published guidelines recommending no corticosteroid injections for the two weeks prior to, and the one week following, a vaccination dose:

Mark Mamlouk

@MarkMamloukMD

4 years

@PeterGKranz @TimAmrheinMD @The_ASSR @TimAmrheinMD: great presentation, slides, and delivery!. Any specific recommendations on spine injections in temporal relation to #COVID19 vaccine?.

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Tim Amrhein, MD

@TimAmrheinMD

5 years

Absolutely! Critical. Although with pervasive misdiagnosis we will still underestimate. .

Spinal CSF Leak Foundation

@spinalCSFleak

5 years

@TimAmrheinMD Now that we have ICD-10 codes, let's find out how common.

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Tim Amrhein, MD

@TimAmrheinMD

5 years

RT @spinalCSFleak: @PeterGKranz @TimAmrheinMD @TheAJNR There is a downloadable PDF of new codes here:

spinalcsfleak.org

Learn about the new ICD-10 diagnostic codes for intracranial hypotension and spinal CSF leak, made possible by the efforts of the Spinal CSF Leak Foundation

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Tim Amrhein, MD

@TimAmrheinMD

5 years

Thanks so much for having us! This was a lot of fun. Happy to continue the conversation anytime #SIH #assr #ajnr @PeterGKranz @TheAJNR @The_ASSR @spinalCSFleak.

American Society of Spine Radiology (ASSR)

@The_ASSR

5 years

Thank you all! Many, many thanks espcially to @TimAmrheinMD & @PeterGKranz. Having the experts host these conversations is crucial for us to use this unique platform for education and awareness. #ASSR #AJNR.

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Tim Amrhein, MD

@TimAmrheinMD

5 years

SIH is likely WAY more common than currently recognized. Be on the lookout in your clinical practice. it may be seeing you, if you're not seeing it. #assr #ajnr.

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Tim Amrhein, MD

@TimAmrheinMD

5 years

Great question and thanks for asking! PATCH feasibility trial (single center at Duke) - closed. Demonstrates excellent feasibility for enrollment and blinding. On to multi-center RCT! #assr #asnr.

Dan Scoffings

@brainscandan

5 years

@TimAmrheinMD T5 What is the current status of the PATCHES trial? #assr #ajnr.

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Tim Amrhein, MD

@TimAmrheinMD

5 years

We desperately need prospective RCTs evaluating efficacy of EBP and surgery. 1st need to prove efficacy: 40% sham response in surgical RCTs. Eventually need comparative RCTs. There are currently 0 published trials! #assr #ajnr.

AJNR

@TheAJNR

5 years

Topic 5: What future directions or future research is still needed to better diagnose and treat SIH?. #AJNR #ASSR

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Tim Amrhein, MD

@TimAmrheinMD

5 years

Here's the CT guided needle approach (not for the faint of heart):

Tim Amrhein, MD

@TimAmrheinMD

5 years

Great question! Still unknown. #workinprogress. Some pts do respond to patching. Many with large spiculated disc osteophytes require surgery. I try patching first, but have lower threshold for surgery. #assr #ajnr.

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Tim Amrhein, MD

@TimAmrheinMD

5 years

Great question! Still unknown. #workinprogress. Some pts do respond to patching. Many with large spiculated disc osteophytes require surgery. I try patching first, but have lower threshold for surgery. #assr #ajnr.

Dan Scoffings

@brainscandan

5 years

@TheAJNR T4 How about patients with large ventral collections - how successful is transforaminal patching for those in your experience at Duke #assr #ajnr?.

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