Micah Etter, MD

What are the perceptions of clinicians referring to a novel pediatric #neuropalliative clinic? In the latest issue of #pedneuro, Lin et al explores these perceptions.

Read here: buff.ly/v2nBte7

Map of the USA illustrating 'Emergency Medicaid Spending for Undocumented Immigrants in the US.' States are shaded in colors ranging from light green (1%) to dark blue (2%), representing the emergency Medicaid share of Medicaid spending. JAMA, published online October 9, 2025.

Emergency Medicaid accounts for less than 1% of total #Medicaid spending, even in states with large undocumented populations.

ja.ma/3Yx9hDD

Brainstem lesions in MS are also perivenular, often appearing radially in a "sunray" pattern. Authors include Dr. Gavin Giovannoni and Dr. Dr. Klaus Schmierer pubmed.ncbi.nlm.nih.gov/41447908/

State Medicaid Expansions and Mortality, Revisited: A Cost-Benefit Analysis | American Journal of Health Economics: Vol 3, No 3 Previous research found that Medicaid expansions in New York, Arizona, and Maine in the early 2000s reduced mortality. I revisit this question with improved data and methods, exploring distinct causes...

State Medicaid Expansions and Mortality, Revisited:

Medicaid expansions led to declines in all-cause mortality of 6%; HIV-related mortality accounted for 20 percent of the effect.
www.journals.uchicago.edu/doi/abs/10.1...

JAMA infographic: study on valacyclovir for Alzheimer's. Question: Can valacyclovir provide benefit? Conclusion: Not efficacious. Population: 66 women, 54 men, mean age 71.4. Intervention: 120 patients randomized to valacyclovir or placebo. Findings: Valacyclovir worsened cognition vs. placebo.

Valacyclovir was associated with greater cognitive decline and did not improve disease markers in patients with symptomatic #AlzheimerDisease and HSV seropositivity.

ja.ma/4qydeE1

1/ 👋 there #neurotwitter #neurosky #neurocritcare, and Happy Holidays if you celebrate! As part of my @neurocritcarej #SoMeAmbassador role, today we will be breaking down the following article: link.springer.com/ar... about consent in research involving #DoC

new cases/images will be added over time! see something missing or broken? tell me! 🆒

@rkchoi.bsky.social
@zachlondon.bsky.social
@caseyalbin.bsky.social
@birdreader.bsky.social
@cajalbutterfly.bsky.social
@radhikarawat.bsky.social
@thejugglingneuron.bsky.social
@klstenhouse.bsky.social

🚨NEW RELEASE THING🚨

new at: micahetter.me/NeuroPathGal...

"NeuroPath Gallery" - a neuropath case + image gallery for rapid pattern recognition and board review. browse diagnoses, key slide findings, and quiz yourself! 🧠🔬

the most fun you've ever had looking at tissue!😅

HEY EVERYBODY!

i'm back! did you miss me?🙃

i was so busy co-directing the neuro block
@UAZMedTucson
for 1st year med students that I haven't been around as much... but it gave me time to make LOTS of fun stuff!

i'll be gradually releasing, but let's start with...**drumroll**

Prospective Trial of Cerebrospinal Fluid Filtration After Aneurysmal Subarachnoid Hemorrhage via Lumbar Catheter Extension (PILLAR-XT) Neurocritical Care - There is a growing consensus that blood in the cerebrospinal fluid (CSF) is deleterious to outcomes in patients with aneurysmal subarachnoid hemorrhage. The extracorporeal...

1/ 👋 there #neurotwitter #neurocritcare, as part of my @neurocritcarej #SoMeAmbassador role, today we will be breaking down the following article:

The Applicant’s Guide to Strategic Preference Signaling Whenever I discuss preference signaling on social media, one of the first replies is always “Wait – what’s that?” In the olden days, when an applicant was interested in a particular residency…

On September 24, ERAS will open to programs. Which means applicants have only 2 weeks left to decide which programs to signal.

And if you want to know how to allocate your signals in the most effective manner possible, I’ve got something for you:

thesheriffofsodium.com/2025/09/10/t...

1/ Hello #medsky #neurosky #neurocritcare #FOAMEd have another brief case that I wanted to discuss with you and see if maybe you can learn something new or reinforce old knowledge!

🚨NEW RELEASE🚨

🔍Daily neurology connections, anyone?

neuroconnections.me has launched with a free, fun micro-learning puzzle game every day! Still the initial release so let me know if you spot any bugs.🐛

Play and learn here: neuroconnections.me

#Neurology #MedEd

🚨New thing release announcement! 🚨

StrokeBot.me is a free stroke code simulator for trainees! Practice workflows, interventions, disposition calls, and more!

This is just the initial release so bugs are expected and updates ongoing! Enjoy!

#Neurology #MedEd

lithium ion trapped by beta-amyloid and the way to get around it

Could a metal ion supplement that cost pennies per day protect from Alzheimer's disease?
erictopol.substack.com/p/lithium-an...

Bottle of synthroid next to simple anatomical drawing of thyroid gland Bottle of chrome next to brighter illustration of thyroid gland Packet of liotrix next to positively glowing illustration of thyroid gland Bottle of armour thyroid next to cosmically significant illustration of thyroid gland Pubmed headline “An outbreak of thyrotoxicosis caused by the consumption of bovine thyroid gland in ground beef” next extremely bright illustration of thyroid gland overlaying the pillars of creation nebula

1/ Hello #medsky #neurosky #neurocritcare #FOAMEd have a brief case that I wanted discuss with you and see if maybe you can learn something new or reinforce old knowledge!

Image Challenge What is the diagnosis? Upper left: MRI of the brain showing diffuse pachymeningeal enhancement. Lower left: A computed tomographic myelogram. Right: MRI showing protrusion of the cerebellar tonsils into the foramen magnum (tonsillar ectopia), flattening of the pons with effacement of the prepontine cistern, and enlargement of the pituitary gland owing to increased blood flow.

A 50-year-old woman presented to the emergency department with a 10-day history of a throbbing headache that had suddenly started after she had felt a “pop” in her back. The headache worsened with upright positioning and improved with lying flat. 1/4

#MedSky

Just the facts: rivastigmine for the management of anticholinergic toxicity - Canadian Journal of Emergency Medicine Canadian Journal of Emergency Medicine -

Case series w/ cumulative total n=110 pts support use of rivastigmine as alternative antidote to physostigmine for anticholinergic delirium. Both oral & transdermal formulations of rivastigmine may expedite recovery #medsky #EMsky #pharmsky #emimcc #FOAMed

👉 link.springer.com/article/10.1...

OpenEvidence is generally very good, but it's occasionally horrifically wrong

One place it falls down a lot is drug allergy (where it's often too conservative)

There are NO absolute contraindications to acetylcysteine for acetaminophen OD

Reported "allergy" = anaphylactoid rxns... (#1/3) #EMIMCC

Prodromal phase of multiple sclerosis: evidence from sickness absence patterns before disease onset – a matched cohort study Background We aimed to investigate the prodromal phase of multiple sclerosis (MS) by investigating annual sickness absence rates before MS onset. Methods A retrospective cohort study was conducted us...

You had MS even before you had symptoms. This study found increased absenteeism from work 6 years prior to diagnosis. jnnp.bmj.com/content/earl...

This is what we were waiting for. A direct comparison between apixaban and rivaroxaban for the treatment of acute VTE. Apixaban reduces bleeding risk in the first 3 months by >50%!

Practice changing investigator-initiated RCT.

#ISTH2025

A web-comic that says "A Simple Guide to Using AI in Peer Review" with one panel that says "Wrong Way" and the next panel says "Right Way."

Peer review is being transformed by AI, whether we like it or not.

From my own experience, most researchers are using it wrong… and that’s because no one’s talking about it! Let me share some ideas on how to harness its potential to improve scientific publishing.

Herpes Zoster Vaccination and Dementia Occurrence

Herpes zoster vaccination eligibility reduced the probability of new dementia diagnoses, suggesting its potential preventive effect.

https://ja.ma/4lagSB6

What is the prevalence of elevated opening pressure in children with Alexander Disease?

In the current issue of #pedneuro journal, Joung et al. explore this question through analysis of opening pressure, MRI and examination in a cohort of 43 patients.

Read Here: buff.ly/UrvyLjh

INDEX trial: CT perfusion wasn't adequate for evaluating brain death.

huge problem: they're using clinical exam as the gold standard

I think most patients classified as brain dead by CT perfusion but alive by exam were dead... #1/2

#EMIMCC #CCR25

Diagnostic performance of plasma p‐tau217 and Aβ42/40 biomarkers in the outpatient memory clinic INTRODUCTION Plasma biomarkers of Alzheimer's disease (AD) represent accessible alternatives to positron emission tomography (PET) and cerebrospinal fluid (CSF)-based biomarkers in well-characterize.....

"Plasma p-tau217 reliably identified clinic patients with Alzheimer's"🆒

"definitive results in 86% of patients" 🆒

"Integration of plasma Aβ42 minimally improved diagnostic performance"🐟

"Plasma p-tau217 levels were increased in patients with kidney dysfunction"🫘

ICH Calculator One Stop Shop

🚨 Excited to announce my brand-new, all-in-one ICH calculator page! It brings together multiple intracerebral hemorrhage stroke calculators in one comprehensive spot for assessments + decisions. 🧠🩸

Explore, use, share, and REMIX!💿📼
Check it out here: tinyurl.com/ICHcalc

#ThrowbackThursday to our episode on DAPT 🩸

Did you know that ticagrelor inhibits adenosine reuptake, which can cause bradycardia and dyspnea, sometimes resulting in patient self-discontinuation ‼️

www.coreimpodcast.com/2021/04/07/5...

The Journal of the American Medical Association, Vol XXXIX, Chicago, Illinois, November 8, 1902 Addresses. Memorial to the late J.T. Eskridge, M.D., of Denver, Colo. Chairman of the Section on Neurology of the American Medical Association. Charles K. Mills, M.D. Philadelphia and Frank P. Norbury, M.D. Jacksonville, Ill.

For reasons, I was reading the 1902 memorial of early American neurologist J.T. Eskridge this morning - and Frank Norbury has some delightful thoughts on enthusiasm that I thought I'd share 1/5