Jefferson Digital Commons

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  Improving Bedside Procedural Safety through Optimizing Timeout Documentation and a Pre-procedure Checklist

  Jennifer Harris, MD; R. Benson Jones, MD; Kristin Lohr, MD; Grant Turner, MD; Drew Kotler, MD; Justine Blum, MD; Megan Margiotta, MD; Matthew Bokhari, MD; Erica Li, MD; Riti Kanesa-thasan, MD; Bracken Babula, MD; and Rebecca Jaffe, MD

  Aim

  GOAL: Improve the safety of patients undergoing bedside procedures while maintaining the full spectrum of graduated autonomy in procedure training for residents.

  SMART Aim: Increase the rate of timeouts documented for bedside procedures from 29% to 50% by June 2018.

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  Reorganization of Thalamic Intrinsic Connectivity Following Anterior Temporal Lobectomy

  Xiaosong He, Chaitanya Ganne, Michael R. Sperling, Ashwini Sharan, and Joseph I. Tracy

  The thalamus has played a crucial role in determining surgical outcome following anterior temporal lobectomy (ATL) in temporal lobe epilepsy (TLE) (He, et al., 2017). Before successfully quantifying the impact of the thalamus on ATL outcomes, this structure’s own intrinsic connectivity must be understood. Accordingly, we characterize thalamic intrinsic connectivity through resting-state fMRI (rsfMRI) longitudinally, exploring its change pre- to post-surgery.

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  Ictal Asystole in a patient with posterior reversible encephalopathy syndrome (pres) and seizures: A Case Report

  Joanna Suski, MD; Reginald T. Ho, MD; and Maromi Nei, MD

  BACKGROUND

  • Ictal asystole is rare, seen in less than 1% of patients with epilepsy, and typically seen in patients with temporal or frontal lobe seizures, rarely in occipital lobe seizures, and has never been described in a patient with PRES .
  • PRES is a clinical-radiologic diagnosis in which there is a breakdown of the blood brain barrier caused by abrupt changes of blood pressure, or cytokines causing endothelial damage and this creates brain edema.
  • The typical neurological symptoms of PRES include encephalopathy (50-80%), seizure (60-75%), headache (50%), and visual disturbance (35%).
  • Brain imaging in PRES usually reveals vasogenic edema in the bilateral parietal-occipital regions, and may include the frontal, temporal, basal ganglia, brainstem or cerebellum.
  • Most patients with PRES have a favorable outcome but mortality can be as high as 3-6%, persistent neurological sequela in 10-20% of patients, and recurrent PRES in 5-10%.