Our Neuro Network

04/30/2026

🥳Happy Ehlers-Danlos Awareness
Month🥳

is happy you are here and to spread awareness about the neurological implications and manifestations of EDS.

Join us, and check out our free resources, podcast, blog, and website.

Link in Bio.

04/30/2026

The U.S. Department of Education has finalized a rule with direct consequences for our communities and the future of health care access in this country. By removing advanced nursing degrees from the federal definition of a “professional degree,” access to federal student loan funding for graduate nursing education is substantially reduced. This impacts nurse practitioners, master’s-prepared nurses, and doctorally prepared nurses, including PhD-trained researchers and educators.

The downstream effect will not be abstract. It will be felt in our communities, families, and homes. Fewer students will be able to pursue advanced nursing education. Fewer clinicians will enter the workforce. Fewer researchers will advance the science. Fewer educators will train the next generation.

In a system already strained by workforce shortages, this means longer wait times, reduced access to specialty care, and widening gaps in rural and underserved areas. Fewer Americans will be able to access the skilled healthcare providers, workers, and researchers they deserve.

When we restrict the pipeline, we restrict access and harm our communities.
This is not simply education policy. It is community health policy.

Our patients, families, and country will bear the consequences of reduced access to care. This blatantly harmful decision warrants urgent reassessment.

Tiffany Hoke, DNP, RN, RNP, APRN-RX, AGACNP-BC, SCRN, CNRN
CEO | Neuroscience and Neurovascular Nurse Practitioner | Coach | Consultant | Podcast Host
Our Neuro Network
Website: www.ourneuronetwork.org
E-mail: connect@ourneuronetwork.org
Calendly Appointment Booking Page: calendly.com/ourneuronetwork
Telehealth Phone: 808-295-4021
Telehealth Fax: 808-666-9212
Podcast, Coaching, & Consulting Phone: 307-335-4968
Podcast, Coaching & Consulting Fax: 307-312-3277

https://www.aanp.org/news-feed/department-of-education-rule-will-harm-our-nations-health-care-workforce

04/29/2026

A word on accessibility and assistive devices for those with CSF leak and intracranial pressure disorders:

04/22/2026

🧬 KETO + MC4R DEFICIENCY: WHY IT HELPS — AND THE ONE RISK TO RESPECT

If you have MC4R deficiency, a ketogenic diet can be powerful.

✅ THE BENEFITS

🔋 Stable daytime energy — ketones fuel the brain without the glucose rollercoaster.
📉 Smoother blood sugar — fewer spikes and crashes, improved time-in-range (~62% → ~87%).
💪 Improved insulin sensitivity — seen within weeks.
🧠 Sharper cognition — ketones increase cerebral blood flow and efficiency.
🔥 Reduced inflammation — BHB modulates NLRP3 and epigenetic signaling.
🍽 Reduced hyperphagia — aligns with melanocortin pathway physiology.

⚠️ THE RISK: NOCTURNAL HYPOGLYCEMIA

MC4R deficiency often means high insulin + impaired counterregulation. On keto, without incoming carbs, glucose can drop — especially overnight.

Why this pattern (like in this CGM)?
→ Persistent insulin effect
→ Blunted glucagon/adrenaline response
→ Reduced hepatic glucose output
→ Increased renal glucose loss

🛡 HOW TO STAY SAFE

1️⃣ CGM is essential — set low alert ~70 mg/dL
2️⃣ Bedtime snack — nuts, cheese, avocado
3️⃣ Avoid long fasts >10–12 hours
4️⃣ Skip alcohol at night
5️⃣ Keep glucose tabs bedside — treat

04/15/2026

Cerebral venous congestion can cause these emergent neuro-ocular warning signs. Don’t miss them!!!!!!

dural arteriovenous fistula can present with proptosis, conjunctival injection, and ophthalmoplegia; endovascular embolization achieved complete occlusion and rapid symptom resolution in this case.

https://ja.ma/4vwowM4

04/03/2026

A word about intracranial pressure, our biases, and important considerations to guide our mission honoring truth and our journey toward healing.

04/02/2026

Nine years ago today, I woke up with a facial (VII) nerve palsy from a congested, laterally positioned right jugular bulb eroding into my stylomastoid foramen.

It was accompanied by severe great auricular neuralgia and trigeminal neuralgia in the setting of intracranial hypertension from cerebral venous congestion. At the time, I thought my cancer had metastasized. I am grateful I was wrong.

Here, you can appreciate another cranial neuropathy that can accompany venous congestion: spinal accessory nerve (XI) palsy.

Left-sided scapular winging with preserved shoulder elevation due to trapezius compensation is consistent with partial spinal accessory nerve dysfunction, which is often missed unless you directly visualize or palpate the scapula as it moves.

I have also had right vagal (X) nerve dysfunction with a leftward-deviated uvula and spasmodic dysphonia.

Cranial nerve VII at the stylomastoid foramen, and cranial nerves X and XI at the jugular foramen and carotid sheath, can all be affected in intracranial hypertension with jugular venous compression.

These are localizing neurological signs. It is not a mystery.

Would you spot it, if it happened to your patient, if it happened to you?

03/31/2026

When you adapt, you facilitate recruitment of novel neural reserves and stimulate neuroplasticity. In other words, those who have encountered more resistance develop the skill of persistence. This is how people with significant neurological impairment and disability do amazing and incredible things.

To adapt requires commitment to a goal, vision, flexibility, courage, and patience. It can take you some time to learn how to accomplish your mission in your own way, but where there is a will, there is a way.

Do I wish to work recumbent? No, but I can, I will, and it will be worth my while because my effort, applied over time, makes it so. It does not happen overnight, arrival; but the journey has already begun. Life is now, and with gratitude, I live it to the fullest of my ability.

02/21/2026

Check out Our Neuro Network’s Latest Podcast on Apple and Spotify. Video episodes are now on You Tube!!!

Mast Cell Activation Syndrome, Chemical Sensitivity, and Jugular Venous Congestion: A Big Picture Perspective

In this episode, host and Our Neuro’ Networks CEO, Neuroscience, and Neurovascular Nurse Practitioner Tiffany Hoke, DNP, RN, RNP, APRN-RX, AGACNP-BC, SCRN, CNRN addresses a common question: Is MCAS caused by jugular venous congestion, and will improving drainage fix it?

LINKS IN BIO & BELOW

https://www.youtube.com/

https://podcasts.apple.com/us/podcast/our-neuro-network/id1841175096

https://open.spotify.com/show/6bsa3fcXUetNqPD0wkAW1a?si=906d503445834c44

02/02/2026

High-performing, driven, perfectionistic people are often the most vulnerable to cerebral venous, CSF, and migraine disorders when rest and recovery are neglected. I learned this the hard way.

Healing required more than procedures. It required regulation.

Rest is not indulgence.

Self-care is not optional.

This is physiology.

This is homeostasis.

🧠 New blog post:
High Performance, Overextension, and the Physiology of Healing

I share the science, lived experience, and the framework that transformed my recovery, along with the daily affirmation that anchors my self-care practice.

🔗 Read here:
https://ourneuronetwork.org/high-performance-overextension-and-the-physiology-of-healing (link in Bio and Story)

Daily Affirmation:

All is as it should be.

My worth is inherent. It requires no achievement, no striving, no proof.

I am whole. I am complete. Everything else is abundance.

I am free to pause, to breathe, to recover in ways that honor my body, mind, and spirit.

I need no permission to care for myself with intention and love.

This is homeostasis.

01/28/2026

🔬 Optic Nerve Ultrasound & Intracranial Pressure (ICP)

Bedside ultrasound of optic nerve sheath diameter (ONSD) and optic disc elevation (ODE) provides rapid, non-invasive screening for intracranial pressure abnormalities.

• ONSD: ~90% sensitivity, ~85% specificity; cutoff 5.0–5.7 mm
• ODE ≥0.6 mm detects papilledema (~82% sensitivity)
• Combined ONSD + ODE: 93% sensitivity, 92% specificity
• Intracranial hypotension: ~10% ONSD reduction supine→upright (AUC ≈ 0.87)

Accuracy depends on standardized technique and training.

⸻

References

Koziarz, A., Sne, N., Kegel, F., et al. (2019). Bedside optic nerve ultrasonography for diagnosing increased intracranial pressure: A systematic review and meta-analysis. Annals of Internal Medicine, 171(12), 896–905. https://doi.org/10.7326/M19-0812

Janitschke, D., Stögbauer, J., Lattanzi, S., Brigo, F., & Lochner, P. (2023). B-mode transorbital ultrasonography for the diagnosis of idiopathic intracranial hypertension: An updated systematic review and meta-analysis. Neurological Sciences, 44(12), 4313–4322. https://doi.org/10.1007/s10072-023-07016-z

Malky, I. E., Aita, W. E., Elkordy, A., et al. (2025). Optic nerve sonographic parameters in idiopathic intracranial hypertension: A case-control study. Scientific Reports, 15(1), 1788. https://doi.org/10.1038/s41598-024-85033-4

Berhanu, D., Ferreira, J. C., Abegão Pinto, L., et al. (2023). The role of optic nerve sheath ultrasonography in increased intracranial pressure: A systematic review and meta-analysis. Journal of the Neurological Sciences, 454, 120853. https://doi.org/10.1016/j.jns.2023.120853

01/10/2026

Intracranial Hypertension can be devastating, especially when standard treatments fail.

A new study may be changing what’s possible.

I break down the River Study, what it found, and what it could mean for patients living with IH.

👉 Read more: https://zurl.co/6JsiJ