ABSTRACT
Over the last 10 years, there has been a rise in neurointerventional case complexity, device variety and physician distractions. Even among experienced physicians, this trend challenges our memory and concentration, making it more difficult to remember safety principles and their implications. Checklists are regarded by some as a redundant exercise that wastes time, or as an attack on physician autonomy. However, given the increasing case and disease complexity along with the number of distractions, it is even more important now to have a compelling reminder of safety principles that preserve habits that are susceptible to being overlooked because they seem mundane. Most hospitals have mandated a pre-procedure neurointerventional time-out checklist, but often it ends up being done in a cursory fashion for the primary purpose of 'checking off boxes'. There may be value in iterating the checklist to further emphasize safety and communication. The Federation Assembly of the World Federation of Interventional and Therapeutic Neuroradiology (WFITN) decided to construct a checklist for neurointerventional cases based on a review of the literature and insights from an expert panel.
ABSTRACT
A man of 30 years, admitted in Neurology unit of Mymensingh Medical College Hospital with weakness of all four limbs for 4 weeks which was of gradual onset and progressive. He had no difficulty in vision, swallowing & speech. He had no disturbances of sensation, bowel & bladder functions. There was no preceding history of gastrointestinal or upper respiratory tract infection or vaccination. General examination was normal except the presence of hypertension detected two months before the onset of current illness. All cranial nerve functions were intact. Muscle power was grade 4 in all limbs and the reflexes were absent. All modalities of sensation and coordination were normal. Cerebro-spinal fluid (CSF) study revealed protein-cell dissociation. Electro physiologic findings were consistent with Chronic Inflammatory Demyelinating Polyneuropathy (CIDP). The patient was treated with prednisolone 60mg/day for two months with improvement of muscle power. The steroid was reduced gradually and then maintained 20mg/day without any relapse.
