Joel Neves Briard
@nevesbriard.ca
📤 244
đź“Ą 130
đź“ť 36
physician-scientist # coma, stroke & status epilepticus université de mtl 🇨🇦
www.lapresse.ca/actualites/c...
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Odile, dans la lumière
J’ai raconté l’histoire d’Odile en 2021. La fibrose kystique, l’attente pour des poumons à 15 ans, la peur de la mort. L’enfance, l’adolescence ponctuées de séjours dans les hôpitaux. Sa survie, grâce...
https://www.lapresse.ca/actualites/chroniques/2025-09-21/odile-dans-la-lumiere.php
18 days ago
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reposted by
Joel Neves Briard
Centre hospitalier de l'Université de Montréal
about 1 month ago
Au CHUM, les inhalothérapeutes, spécialistes incontournables du système cardiorespiratoire font partie de l’équipe d’intervention rapide 2.0 qui intervient auprès des patients qui développent de graves complications. Pour en savoir plus 👇
urls.fr/c7uDrR
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Les compétences des inhalothérapeutes mieux utilisées en contexte de pénurie
MONTRÉAL — Une transformation discrète du rôle des inhalothérapeutes — ces experts du système cardiorespiratoire — s'est mise en branle depuis quelques années au Québec. Au CHUM, ces professionnels de...
https://urls.fr/c7uDrR
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Continuous EEG Monitoring in Canadian Hospitals: A Nationwide Cross-Sectional Survey
www.neurology.org/doi/10.1212/...
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Continuous EEG Monitoring in Canadian Hospitals | Neurology Clinical Practice
Background and ObjectivesContinuous EEG (cEEG) is the gold standard for diagnosing nonconvulsive seizures (NCSs) and nonconvulsive status epilepticus (NCSE) in critically ill patients, with NCSE occur...
https://www.neurology.org/doi/10.1212/CPJ.0000000000200522
about 1 month ago
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reposted by
Joel Neves Briard
La Presse
about 1 month ago
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Don d’organes | Les coulisses d’un processus délicat
Accompagner les familles au pire moment de leur vie. Donner un sens à des drames qui, souvent, n’en ont pas. Sans jamais tenter d’influencer leur choix pour la suite. La Presse a réalisé une rare immersion dans l’univers du don d’organes. Un dossier de Caroline Touzin
https://www.lapresse.ca/actualites/sante/2025-08-30/don-d-organes/les-coulisses-d-un-processus-delicat.php?utm_source=dlvr.it&utm_medium=bluesky&utm_campaign=accueil
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A human brain network linked to restoration of consciousness after deep brain stimulation
www.nature.com/articles/s41...
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A human brain network linked to restoration of consciousness after deep brain stimulation - Nature Communications
In people with severe brain injuries, stimulation restored consciousness by engaging a deep brain circuit for wakefulness—revealing a target that may also guide treatment in stroke and epilepsy.
https://www.nature.com/articles/s41467-025-61988-4?utm_source=rct_congratemailt
about 2 months ago
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A Phase 3 Trial of Inebilizumab in Generalized Myasthenia Gravis | New England Journal of Medicine
www.nejm.org/doi/full/10....
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A Phase 3 Trial of Inebilizumab in Generalized Myasthenia Gravis | NEJM
Autoimmune generalized myasthenia gravis is a disease that manifests with fluctuating muscle weakness. Inebilizumab is a monoclonal antibody that depletes CD19+ B cells, which are central to diseas...
https://www.nejm.org/doi/full/10.1056/NEJMoa2501561?query=neurology-neurosurgery
3 months ago
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More data on this approach just published in the ANGEL-TNK Randomized Clinical Trial !
jamanetwork.com/journals/jam...
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3 months ago
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This systematic review and meta analysis of RCTs found that intra-arterial thrombolysis after endovascular recanalization adds additional benefits to functional outcomes among patients with AIS due to LVO, with no increased risk of death or intracranial hemorrhage.
www.neurology.org/doi/10.1212/...
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Intra-Arterial Thrombolysis Following Endovascular Recanalization for Large Vessel Occlusion Stroke | Neurology
Background and ObjectivesThis systematic review and meta-analysis aims to evaluate the treatment effects of intra-arterial thrombolysis (IAT) after endovascular recanalization in patients with acute i...
https://www.neurology.org/doi/10.1212/WNL.0000000000213842
3 months ago
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reposted by
Joel Neves Briard
JAMA
3 months ago
From JAMA Pediatrics: More screen time is associated with more depressive symptoms, potentially due to shorter sleep and worse white matter organization during early adolescence.
https://ja.ma/3TIXNKz
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Recurrence and Mortality After a First Status Epilepticus: A Retrospective Nationwide Study From the French National Health Data System
www.neurology.org/doi/10.1212/...
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Recurrence and Mortality After a First Status Epilepticus | Neurology
Background and ObjectivesStatus epilepticus (SE) is associated with high short-term mortality, but data on long-term outcomes, including recurrence and mortality, are limited. The aim of this study wa...
https://www.neurology.org/doi/10.1212/WNL.0000000000213693
4 months ago
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Effects of blood pressure lowering in relation to time in acute intracerebral haemorrhage: a pooled analysis of the four INTERACT trials - The Lancet Neurology
www.thelancet.com/journals/lan...
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Effects of blood pressure lowering in relation to time in acute intracerebral haemorrhage: a pooled analysis of the four INTERACT trials
Intensive BP-lowering initiated within several hours of intracerebral haemorrhage onset was safe and improved functional recovery, without a clear effect on haematoma growth. The greatest benefits for...
https://www.thelancet.com/journals/laneur/article/PIIS1474-4422%2825%2900160-7/fulltext
4 months ago
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Congratulations to my mentor Michaël Chassé and all colleagues in the INDex team for completing this work ! What a pleasure working on this together. A great 🇨🇦 collaboration !
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4 months ago
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reposted by
Joel Neves Briard
NEJM.org
4 months ago
Presented at
#CCR25
: In a cluster-randomized, crossover trial, hospital-wide use of lactated Ringer’s solution as compared with normal saline did not alter the incidence of death or hospital readmission within 90 days. Full trial results:
nej.md/45SaEBs
@criticalcarereviews.com
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Oveporexton shows promise for the treatment of narcolepsy in this phase 2 trial. Exciting findings for those impacted by this rare condition and everyone in the sleep medicine community !
www.nejm.org/doi/full/10....
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Oveporexton, an Oral Orexin Receptor 2–Selective Agonist, in Narcolepsy Type 1 | NEJM
Narcolepsy type 1 is a disorder of hypersomnolence caused by a loss of orexin neurons, which results in low orexin levels in the brain. In this phase 2, randomized, placebo-controlled trial, partic...
https://www.nejm.org/doi/full/10.1056/NEJMoa2405847
4 months ago
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reposted by
Joel Neves Briard
JAMA
4 months ago
Most viewed this week from JAMA: Restrictive platelet transfusion strategies are recommended for various clinical populations to minimize adverse reactions, mitigate platelet shortages, reduce costs, and ensure patient-centric care.
https://ja.ma/4jtHFan
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DAYLIGHT study from Western University finds higher rates of cardioaortic thrombus in the extended CT angiography group (8·8%) than the standard CT angiography group (1·7%; odds ratio 5·70, 95% CI 1·92–16·96; p=0·002).
www.thelancet.com/journals/lan...
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Extended CT angiography versus standard CT angiography for the detection of cardioaortic thrombus in patients with ischaemic stroke and transient ischaemic attack (DAYLIGHT): a prospective, randomised...
Performing extended CT angiography during acute code strokes is feasible and results in increased cardioaortic thrombi detection without causing delays in CT angiography completion. Future studies sho...
https://www.thelancet.com/journals/laneur/article/PIIS1474-4422(25)00111-5/abstract?dgcid=raven_jbs_etoc_feature_laneur
5 months ago
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reposted by
Joel Neves Briard
JAMA
5 months ago
In critically ill patients, neither dexmedetomidine nor clonidine was superior to propofol in reducing time to successful extubation. #ATS2025
https://ja.ma/3Sw1K4Z
#ATS2025
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All 25 participants in this study of « New Brunswick Neurological Syndrome of Unknown Cause (NSUC) » had a well known condition diagnosed on second evaluation or neuropathology. Medical, scientific and journalistic rigor are essential in addressing « mystery » cases.
jamanetwork.com/journals/jam...
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Evaluations of the New Brunswick Neurological Syndrome of Unknown Cause
This cross-sectional study examines findings from second, independent clinical evaluations of patients initially diagnosed with an alleged “mystery” neurological illness in New Brunswick, Canada, to d...
https://jamanetwork.com/journals/jamaneurology/fullarticle/2833783?guestAccessKey=babf1320-2c5c-482f-a6f7-6185e77f8450&utm_source=fbpage&utm_medium=social_jamaneur&utm_term=16877478043&utm_campaign=article_alert&linkId=814044054&fbclid=IwZXh0bgNhZW0CMTEAAR73_sUwOa1nYGGOvBs6Gwy6-NaC5yTGQO0FVt3xL81Xm5SNmSgPL2nv9OqvKQ_aem_51XB2XkLdajvdVWkKvZ6Mw
5 months ago
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In this recent study from Québec, door-in-door-out metrics were surprisingly not associated with 90-day functional outcomes or mortality among acute stroke patients treated by EVT following transfer from a primary stroke center.
@crchum.bsky.social
www.cambridge.org/core/journal...
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Door-in-door-out times and functional outcomes after stroke in a large Canadian hub-and-spoke network | Canadian Journal of Neurological Sciences | Cambridge Core
Door-in-door-out times and functional outcomes after stroke in a large Canadian hub-and-spoke network
https://www.cambridge.org/core/journals/canadian-journal-of-neurological-sciences/article/doorindoorout-times-and-functional-outcomes-after-stroke-in-a-large-canadian-hubandspoke-network/25A90D2E9DB39BCDD2B277F7F9083E94
6 months ago
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reposted by
Joel Neves Briard
JAMA
7 months ago
In patients needing coagulation factor replacement after cardiac surgery, prothrombin complex concentrate showed superior hemostatic effectiveness and fewer serious adverse events and acute kidney injuries compared to frozen plasma. #ACC25
https://ja.ma/43w3phs
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In this observational Canadian study, patients with benzodiazepine-refractory status epilepticus who received a higher weight-based dosing of levetiracetam had a higher proportion of seizure termination as compared to the lower weight based group (aOR 3.07).
www.cambridge.org/core/journal...
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Evaluating Levetiracetam Weight-based Dosing in Benzodiazepine-refractory Status Epilepticus | Canadian Journal of Neurological Sciences | Cambridge Core
Evaluating Levetiracetam Weight-based Dosing in Benzodiazepine-refractory Status Epilepticus
https://www.cambridge.org/core/journals/canadian-journal-of-neurological-sciences/article/evaluating-levetiracetam-weightbased-dosing-in-benzodiazepinerefractory-status-epilepticus/6F4AE79B03D3A38F0874CFDC4E5B74C5?utm_campaign=shareaholic&utm_medium=copy_link&utm_source=bookmark
7 months ago
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reposted by
Joel Neves Briard
Eric Topol
7 months ago
The brain myelin content in marathon runners “This study offers the striking observation that extreme exercise has a profound effect in the brain that is reflected in reversible structural alterations"
@naturemetabolism.bsky.social
www.nature.com/articles/s42...
www.nature.com/articles/s42...
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Reversible reduction in brain myelin content upon marathon running - Nature Metabolism
Using magnetic resonance imaging on marathon runners, Ramos-Cabrer, Cabrera-Zubizarreta et al. report that the signal detected as a surrogate of myelin content is significantly reduced after exercise,...
https://www.nature.com/articles/s42255-025-01244-7
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Decisions to withdraw or withhold life-sustaining therapies in patients with and without acute brain injury: a secondary analysis of two prospective cohort studies - The Lancet Respiratory Medicine
www.thelancet.com/journals/lan...
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Decisions to withdraw or withhold life-sustaining therapies in patients with and without acute brain injury: a secondary analysis of two prospective cohort studies
Our findings suggest that WLST decisions are significantly more common in patients with ABI versus patients without ABI and occur earlier in this group. The rationale for early WLST following ABI warr...
https://www.thelancet.com/journals/lanres/article/PIIS2213-2600%2824%2900404-1/fulltext
7 months ago
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Les avancées en neuro-oncologie s’annoncent importantes !
@chumontreal.bsky.social
www.journaldemontreal.com/2025/03/10/c...
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«Ça change tout pour moi»: cette jeune maman atteinte d’un cancer du cerveau a encore de belles années devant elle grâce à un nouveau traitement
Une jeune mère de Terrebonne atteinte d’un cancer du cerveau incurable peut espérer vivre encore plusieurs années en santé grâce à un médicament.
https://www.journaldemontreal.com/2025/03/10/ca-change-tout-pour-moi---une-jeune-maman-de-terrebonne-avec-un-cancer-du-cerveau-a-encore-de-belles-annees-devant-elle-grace-a-un-nouveau-traitement
7 months ago
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reposted by
Joel Neves Briard
Guillaume Emeriaud
7 months ago
Very good summary of the facts and myths about measles. The vaccine saves lives! And it's the antivaxers who make money on the backs of future victims.
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Fascinating findings from the Columbia DoC Lab! Sleep spindles predict cognitive motor dissociation and recovery of consciousness after acute brain injury
rdcu.be/ech6L
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Sleep spindles as a predictor of cognitive motor dissociation and recovery of consciousness after acute brain injury
Nature Medicine - In acutely brain injured patients, well-formed sleep spindles on EEG were more likely present in patients with cognitive motor dissociation, were associated with a shorter time to...
https://rdcu.be/ech6L
7 months ago
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Antiseizure Medications in Poststroke Seizures A Systematic Review and Network Meta-Analysis
www.neurology.org/doi/10.1212/...
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Neurology® Journals
https://www.neurology.org/doi/10.1212/WNL.0000000000210231
8 months ago
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The Brussels consensus for non-invasive ICP monitoring when invasive systems are not available in the care of TBI patients (the B-ICONIC consensus, recommendations, and management algorithm)
link.springer.com/article/10.1...
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The Brussels consensus for non-invasive ICP monitoring when invasive systems are not available in the care of TBI patients (the B-ICONIC consensus, recommendations, and management algorithm) - Intensi...
Background Invasive systems are commonly used for monitoring intracranial pressure (ICP) in traumatic brain injury (TBI) and are considered the gold standard. The availability of invasive ICP monitori...
https://link.springer.com/article/10.1007/s00134-024-07756-2
8 months ago
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Voulez-vous vraiment que les médecins restent ?
www.lapresse.ca/dialogue/opi...
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Cinq ans de pratique obligatoire au public | Voulez-vous vraiment que les médecins restent ?
Les cosignataires s’adressent au ministre de la Santé et à la PDG de Santé Québec
https://www.lapresse.ca/dialogue/opinions/2025-02-06/cinq-ans-de-pratique-obligatoire-au-public/voulez-vous-vraiment-que-les-medecins-restent.php
8 months ago
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In this latest Canadian study, EVT for acute stroke due to medium vessel occlusion did not reduce neurologic disability at 90 days. Higher proportions of ICH and death in the EVT group.
www.nejm.org/doi/full/10....
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Endovascular Treatment of Stroke Due to Medium-Vessel Occlusion | NEJM
Whether the large effect size of endovascular thrombectomy (EVT) for stroke due to large-vessel occlusion applies to stroke due to medium-vessel occlusion is unclear. In a multicenter, prospective,...
https://www.nejm.org/doi/full/10.1056/NEJMoa2411668
8 months ago
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reposted by
Joel Neves Briard
Critical Care Reviews
8 months ago
The ninth trial result for
#CCR25
in Titanic Belfast in June is INdex CT-perfusion for the Neurological Determination of Death Investigators - Michaël Chassé & Jai Shankar Register at
https://criticalcarereviews.com/meetings/ccr25
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In this porcine model we found no evidence of brain blood flow or electrical activity during TA-NRP despite occasional collateral extracranial blood flow. More work needed to understand the impact of TA-NRP on brain physiology in different human donor populations.
www.jhltopen.org/article/S295...
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Thoraco-abdominal normothermic regional perfusion does not restore cerebral blood flow or electrical activity despite collateral supra-aortic blood flow in a porcine model
It is unknown whether ligation of supra-aortic vessels during thoraco-abdominal normothermic regional perfusion (TA-NRP) can prevent postmortem brain function, ensuring the permanence of death. Our ob...
https://www.jhltopen.org/article/S2950-1334(25)00016-3/fulltext
8 months ago
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Very interesting ancillary study shedding light on the potential role of anticoagulation in patients with recent cryptogenic stroke and atrial cardiopathy.
jamanetwork.com/journals/jam...
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Apixaban to Prevent Infarcts After Stroke in Patients With Atrial Cardiopathy
This secondary analysis of a parallel-design double-blind secondary stroke prevention trial in patients with cryptogenic stroke and atrial cardiopathy evaluates the association between apixaban and th...
https://jamanetwork.com/journals/jamaneurology/fullarticle/2829262
9 months ago
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According to this systematic review, COX2 inhibitors have never been studied for the management of headache in patients with acute brain injury. A definitive major knowledge gap for neurocritical care patients!
link.springer.com/article/10.1...
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Cyclooxygenase 2 Inhibitors for Headache After Elective Cranial Neurosurgery: Results from a Systematic Review of Efficacy of Cyclooxygenase 2 Inhibitors for Headache After Acute Brain Injury - Neuroc...
Headache management after acute brain injury (ABI) is challenging. Although opioids are commonly used, selective cyclooxygenase 2 inhibitors (COXIBs) may be promising alternatives. However, concerns a...
https://link.springer.com/article/10.1007/s12028-024-02114-y
9 months ago
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Une autre superbe initiative du groupe neurovasculaire du
@chumontreal.bsky.social
!
ici.radio-canada.ca/nouvelle/212...
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Des appels Teams pour mieux traiter les AVC
1,9 million de cellules cérébrales meurent à chaque minute après un AVC. Pour offrir un traitement plus rapide et efficace, le CHUM mise sur les appels Teams.
https://ici.radio-canada.ca/nouvelle/2128169/sante-appel-visio-teams-avc
9 months ago
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An excellent contemporary review of Guillain Barré syndrome, a condition not to miss - or underestimate !
www.nature.com/articles/s41...
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Guillain–Barré syndrome - Nature Reviews Disease Primers
Guillain–Barré syndrome is an acute immune-mediated polyneuropathy that can occur following infections or other rare triggers. In this Primer, Leonhard and colleagues summarize the epidemiology, mecha...
https://www.nature.com/articles/s41572-024-00580-4
9 months ago
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reposted by
Joel Neves Briard
Centre hospitalier de l'Université de Montréal
10 months ago
Le CHUM est fier d’annoncer que suite à la dernière visite d’Agrément Canada, il obtient une nouvelle fois la prestigieuse Distinction™ AVC pour les services prodigués aux personnes ayant subi un AVC en phase aiguë 👏 Pour en savoir plus 👉
www.chumontreal.qc.ca/actualites/a...
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Fantastic Canadian study! How will we integrate these results with the TRAIN and HEMOTION trials to guide our practice at the bedside?
www.nejm.org/doi/full/10....
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Liberal or Restrictive Transfusion Strategy in Aneurysmal Subarachnoid Hemorrhage | NEJM
The effect of a liberal red-cell transfusion strategy as compared with a restrictive strategy in patients during the critical care period after an aneurysmal subarachnoid hemorrhage is unclear. We ...
https://www.nejm.org/doi/full/10.1056/NEJMoa2410962
10 months ago
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Interesting observational study on the effect of prehospital mobile stroke units on patient outcomes at hospital discharge. More work required for estimation of effect (RCT?), cost effectiveness and feasibility in different settings.
@jama.com
jamanetwork.com/journals/jam...
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https://jamanetwork.com/journals/jamaneurology/fullarticle/2824954
10 months ago
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This secondary analysis of the ORANGE study found that NPi / automated pupillometry is not a reliable tool to monitor intracranial pressure in acutely brain injured individuals.
jamanetwork.com/journals/jam...
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Neurological Pupil Index and Intracranial Hypertension in Patients With Acute Brain Injury
This secondary analysis of the ORANGE study evaluates whether an association exists between the Neurological Pupil Index and invasive intracranial pressure.
https://jamanetwork.com/journals/jamaneurology/fullarticle/2827730
10 months ago
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Cette gauche qui creuse sa propre tombe -
@lapresse.ca
lp.ca/9s4SgF?shari...
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Cette gauche qui creuse sa propre tombe
Si vous voulez bâtir un parti voué à l’autodestruction ou à la marginalité permanente, j’ai une recette pour vous.
https://lp.ca/9s4SgF?sharing=true
10 months ago
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Factors Associated with Withdrawal of Life Sustaining Therapy After Out-of-Hospital Cardiac Arrest
www.sciencedirect.com/science/arti...
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Factors Associated with Withdrawal of Life Sustaining Therapy After Out-of-Hospital Cardiac Arrest
Out-of-Hospital Cardiac Arrest (OHCA) is a leading cause of global mortality. Most patients suffer from hypoxic brain injury, which often leads to the…
https://www.sciencedirect.com/science/article/pii/S2589790X24005936
11 months ago
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Québec tarde à implanter plus de défibrillateurs dans des lieux publics
lp.ca/eW3v2G?shari...
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Québec tarde à implanter plus de défibrillateurs dans des lieux publics
Bonifier l’accès aux défibrillateurs externes automatisés (DEA) permettrait d’augmenter de près de 50 % le nombre de survivants d’un arrêt cardiaque, selon la Fondation Jacques-de Champlain. Elle déno...
https://lp.ca/eW3v2G?sharing=true
11 months ago
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reposted by
Joel Neves Briard
Romain Barthélémy
11 months ago
Middle Meningeal Artery Embolization for Nonacute Subdural Hematoma: 3 RCT with consistent results published in NEJM. Becoming the standard of care overnight!
www.nejm.org/doi/full/10....
www.nejm.org/doi/full/10....
www.nejm.org/doi/full/10....
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Adjunctive Middle Meningeal Artery Embolization for Subdural Hematoma | NEJM
Subacute and chronic subdural hematomas are common and frequently recur after surgical evacuation. The effect of adjunctive middle meningeal artery embolization on the risk of reoperation remains u...
https://www.nejm.org/doi/full/10.1056/NEJMoa2313472
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reposted by
Joel Neves Briard
Joel Topf
11 months ago
Honey, stop what you're doing, new hyponatremia research just dropped! What's it say? It looks like slow correction is associated with worse outcomes, like death and length of stay! Was it just a small study? No, it was a meta-analysis of almost 12,000 patients!
jamanetwork.com/journals/jam...
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Correction Rates and Clinical Outcomes in Hospitalized Adults With Severe Hyponatremia
This systematic review and meta-analysis evaluates the association of sodium correction rates with mortality among hospitalized adults with severe hyponatremia.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2826087
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Lots of fun and learning at CCCF with the
@umontreal.bsky.social
crew!
11 months ago
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