Podcasts about stroke center

Whether it's the acute care during the medical emergency or the recovery and rehabilitation that follows, UConn Health continues to earn recognition for its stroke care. Dr. Priya Narwal, interim medical director of UConn Health's Stroke Center, Brooke Medel, stroke nurse navigator, and nurse Kristen Bryant, interim stroke coordinator, share their expertise, and remind us that BEFAST (Balance, Eyes, Face, Arm, Speech, Time) is still the mantra when it comes to recognizing and reacting to stroke. (Dr. Priya Narwal, Brooke Medel, Kristen Bryant, Chris DeFrancesco, May 2024) UConn Health Stroke Center https://health.uconn.edu/stroke-center/ Dr. Priya Narwal https://health.uconn.edu/find-a-provider/physician/Narwal-Priya News on UConn Health stroke care Miracle Outcome for Patient's Life-Threatening Stroke https://today.uconn.edu/?p=214021 First in Connecticut: Ischemic Stroke Survivors Have Renewed Hope With the Vagus Nerve Stimulation Device Now Available at UConn Health https://today.uconn.edu/?p=214132

Wohin mit dem Schlaganfall? Stroke Center, Unit, Regional oder ganz egal? In dieser Folge von Rettungsdienst LUKS - Der Notfallmedizin Podcast lernen wir den RACE Score als Tool für die präklinische Triageentscheidung kennen. In dieser Folge: - Fallbeispiel akutes und neu aufgetretenes fokal neurologisches Defizit mit und ohne RACE Score- Der RACE Score Schritt für Schritt erklärtZum Mitlesen: https://www.heart.org/-/media/files/affiliates/mwa/nebraska-ml-stroke/hospital-toolkit/race.pdf Homepage des Rettungsdienst LUKS: https://www.luks.ch/standorte/standort-luzern/rettungsdienst-und-sanitaetsnotruf-144-zentralschweizFolge zum Thema Einsatzstrategien und Management bei akutem Schlaganfall - Präklinische Herausforderungen (und zu allen anderen Folgen):https://pod.link/1672980207 Weitere Informationen zum RACE Score:https://www.coursera.org/learn/acute-stroke-race-scale http://racescale.org/https://www.nj.gov/health/ems/documents/education/RACE%20Scale_EMS%20Best%20Practices%20Sheet_june21_Final.pdf Alle Evidenzen zu dieser Folge findest du hier: Amboss. (n.d.). Ischämischer Schlaganfall. Abgerufen am 29. Juli 2023, von https://www.amboss.com/de/wissen/ischamischer-schlaganfallSwiss Medical Forum - Schweizerisches Medizinforum. (2021). Prähospitalphase beim akuten Hirnschlag. Swiss Medical Forum - Schweizerisches Medizinforum, 21(19-20), 322-328. doi:10.4414/smf.2021.08726Carrera, D., et. al. (2019). Revalidation of the RACE scale after its regional implementation in Catalonia: a triage tool for large vessel occlusion. Abgerufen am 29. Juli 2023, von https://pubmed.ncbi.nlm.nih.gov/30580284/ Eren, OE., Von Gleichenstein, G., Topka, H. (2023). SOP Schlaganfall. Nofallmedizin up2date 2023, 18: 9-16. DOI:10.1055/a-1925-0975

This episode features Dr. David Wang, Co-Director of the Neurovascular Division & Petznick Stroke Center at Barrow Neurological Institute; Dr. Robert Lemery, Cardiac Electrophysiologist at Arizona Heart Rhythm Center; & Dr. Vijay Swarup, Director of Cardiac Electrophysiology at Arizona Heart Rhythm Center & Director of Electrophysiology at St. Joseph's Hospital. Here, they discuss details surrounding their collaborative work with The Arizona Brain and Heart Symposium taking place October 21st & 22nd, 2022. Learn more at https://www.barrowneuro.org/patient-care/support-resources/education-seminars/the-arizona-brain-and-heart-symposium/

This week, Rusty Keys talks with Dr. Jennifer Majersik, Chief of Vascular Neurology & Stroke Center with the University of Utah Health shares valuable information regarding strokes, symptoms to look for and ways to minimize your risk. See omnystudio.com/listener for privacy information.

Episode #46: An inside look at traumatic brain injury, or “TBI,” and how these injuries influence mental health. People of all ages get them in a variety of ways—from sports injuries, to car accidents, to domestic falls and many of these individuals develop mental health symptoms that can last for months or even years. This show was recorded in Santa Cruz, California, one of the surfing capitals of the country and while mild traumatic brain injuries such as concussions are common in many sports, head injuries are the most common injury among surfers, comprising one-fourth of the total. Children and youths are particularly susceptible and those who sustain even a mild brain injury (often referred to as a concussion), have a 40% increased risk of developing mental health symptoms. Because these issues can appear many months after the injury, doctors and care providers need to pay particular attention to the mental state of patients long after a traumatic brain injury of any severity. Our guest and author JoAnne Jones talks about her recovery from a severe traumatic brain injury that occurred when she was assaulted and robbed. Also with us is rehabilitation and physical medicine specialist Dr. Jennifer Yu who shares information about the mental health symptoms, treatment approaches, and recovery strategies associated with mild to severe traumatic brain injuries. Broadcast: 9/4/22 & 9/13/22 Special thanks  to Jeanne Baldzikowski for audio production, Jennifer Young for underwriting outreach, Lisa Herendeen for research, Leslie Nielsen for “In Your Voice” Coordination and Izzy Weisz for marketing. And thanks to acoustic guitarist Adrian Legg for composing, performing, and donating the use of our theme music. LISTEN ANYTIME or subscribe to get new or past episodes delivered to your listening device: Apple Podcasts / Google Podcasts / Spotify / Stitcher  / TuneIn JOIN EMAIL LIST Want to know our interesting topic each month? Simply  SIGN UP for our email list! FOLLOW US Facebook  @stateofmindksqd Instagram @state_of_mind.radio SUGGEST A TOPIC If you or someone you know has topic ideas for future shows or a story of mental health recovery to share, please email debra.stateofmind@ksqd.org SHARE YOUR STORY In Your Voice are short segments on the show where a listener gets to share their experience of the topic we are discussing. You can call us at 831- 824-4324 and leave a 1-3 minute message about: a mental health experience you've had, something that has contributed to your mental health recovery journey, or share a resource that has helped you. Alternatively, you can make a 1-3 minute audio recording right on your phone and email that file to debra.stateofmind@ksqd.org. Your voice may just become part of one of our future shows! SUPPORT OR UNDERWRITE If you like what you're hearing here on KSQD, also affectionately called K– Squid, you can become a “Philanthropod on the Squid Squad” by becoming a supporting member  and help keep KSQD surfing the air waves! Consider underwriting your business or agency and showing our listeners your support for State of Mind. RESOURCES * Indicates Santa Cruz Local Organizations & Websites Brain Injury Association of California - The Brain Injury Association collectively provides various resources for TBI survivors, caregivers, and professionals. This is the link to the California branch. The Centre for Neuro Skills — In Emeryville, CA has many comprehensive inpatient and outpatient rehabilitation programs for patients recovering from Traumatic Brain Injuries. Brain Injury of America – National organization providing various resources for TBI survivors, caregivers, and professionals. One Hit Away Foundation — Offers resources for healing and preventing sports-related brain injuries caused by a concussion, sub-concussive hits or a Traumatic Brain Injury. This Documentary shares the real-life stories from the surfing community about their relationship with OneHitAway Foundation. The power of being introduced to brain healing / brain health options is changing the way the surfing community views their current and long-term health. Local Santa Cruz Treatment Dominican Hospital Outpatient Rehabilitation Center * — The primary provider of neurological rehabilitative therapy in Santa Cruz. The Stroke Center at Cabrillo College * –Serves adults with acquired disabilities including, but not limited to, TBI. JoAnne's Recommended Resources Yoga. I take classes two days a week. The formal structure and direction is essential. I also try to do yoga poses throughout the day to stay aware of my posture, abdominal muscles and breathing. Yoga and meditation with Karen Zelin * AM Yoga with Rodney Yee Mindful meditation for stress reduction, the model pioneered by Jon Kabat-Zinn Jon Kabat-Zinn's Mindful Website — Everyday mindfulness practices Jon Kabat-Zinn on YouTube Writing — Any form of writing that allows me to let my imagination take over Check out writing courses through Cabrillo College * & Cabrillo College Extension * Writing Classes with Laura Davis * When Covid 19 allows more indoor programming, check out London Nelson Community Center / Santa Cruz Parks and Recreation Classes * Regular exercise: As I age, I don't run as much or lift heavy weights or do as many push-up or mountain climbs. I do walk a few miles each day, try to spend as much, or more time, standing and doing things as I so sitting, and walk my dog or take her to the beach every day Rest. TBI and PTSD exact an energy toll. I've learned to accept the fact that I need to rest each day, in a quiet space. Books & Articles Headstrong: Surviving a traumatic brain injury — by JoAnne Joans. SheWritesPress (2019). Headstrong tells the story of how she learned to live with the daily challenges of TBI. Also available at Bookshop Santa Cruz. Over My Head: A Doctor's Own Story of Head Injury from the Inside Looking Out —by Claudia Osborn. Andrews McMeel Publishing. (1997). Locked inside a brain-injured head looking out at a challenging world is the premise of this extraordinary autobiography. Aftermath: Violence and the remaking of the self — by Susan J. Brison, Princeton University Press. (2002). A personal narrative of recovery and an illuminating philosophical exploration of trauma. Big thrills, dangerous spills: Local nonprofits provide treatment options for surfers who suffer brain injuries — by Jim Seimas | Santa Cruz Sentinel. PUBLISHED: February 13, 2021 at 3:30 p.m. | UPDATED: February 16, 2021 at 10:37 a.m. Mental Health Disorders Common Following Mild Head Injury — NIH-funded study identifies risk factors for neuropsychiatric conditions after concussion. NIH News Release / January 30, 2019. Caregiver Support Del Mar Caregiver Support *—  A Program of Health Projects Center, dedicates their attention and service to caregivers, advocating for public recognition of their worth and value to society while providing low- or no-cost consultations, education, support groups, and respite to caregivers in Santa Cruz, Monterey, and San Benito counties. Family Caregivers Alliance  — Provides services to family caregivers of adults with physical and cognitive impairments, such as Parkinson's, stroke, Alzheimer's and other types of dementia. Services include assessment, care planning, direct care skills, wellness programs, respite services, and legal/financial consultation vouchers. Ongoing support available with FCA, also now on a digital service platform. FCA is a longtime advocate for caregivers in the areas of policy, health and social system development, research, and public awareness, on the state, national and international levels. Offers support groups, classes, resources and events for caregivers and the people who receive their care. AARP Resources to Help Caregivers  — A rich source of educational articles and information to help support caregivers. The National Alliance for Caregiving — An organization dedicated to improving quality of life for friend and family caregivers and those in their care, by advancing research, advocacy, and innovation. Provides research, advocacy and information on resources on caregiving. Contact Guests Jennifer Yu, M.D. (831) 462-4444, Email: jennifer.yu@commonspirit.org Website: Dignity Health JoAnne Joans Phone: (413) 387-3152 Email: joanne.jones1@comcast.net Website: https://joannejonesauthor.com/

Lisa Arnold, Stroke Program Coordinator at Providence Saint John's Health Center and Dr. Reza Bavarsad Shahripour, Vascular Neurologist at Providence Saint John's Health Center Neurovascular and Stroke Center discuss what you need to know about strokes and how to reduce your risk of having a stroke. For more information and resources, visit: providence.org

Stroke center designations are the currency of the realm; but does it matter to patients?

In this classic episode of Aging Matters, Cheryl hosts a conversation with Shannon Burton, ACNP, SCRN, Nurse Practitioner, Stroke Center, MedStar Washington Hospital Center & Lee Stroy, stroke survivor and Ambassador, American Heart Association/American Stroke Association, about causes/risk factors, signs/ symptoms, and treatments for a stroke; also recovery, rehabilitation, and prevention.

On Episode 13 of the Stroke Alert Podcast, host Dr. Negar Asdaghi highlights two articles from the February 2022 issue of Stroke: “Cannabis Use and Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage” and “Infertility, Miscarriage, Stillbirth, and the Risk of Stroke Among Women: A Systematic Review and Meta-Analysis.” She also interviews Dr. Pierre Amarenco about his article “Intracranial Hemorrhage in the TST Trial.” Dr. Negar Asdaghi: 1) Can marijuana use increase the risk of ischemic stroke in patients with aneurysmal subarachnoid hemorrhage? 2) Is there an association between infertility or miscarriage and development of stroke later in life? 3) Does lowering the bad cholesterol increase the risk of intracerebral hemorrhage? We will cover these and much more in today's podcast. This is the latest in Stroke. Stay with us. Dr. Negar Asdaghi:         Welcome to another exciting Stroke Alert Podcast. My name is Negar Asdaghi. I'm an Associate Professor of Neurology at the University of Miami Miller School of Medicine and your host for the monthly Stroke Alert Podcast. Dr. Negar Asdaghi:         The February 2022 issue is the second installment of Stroke's annual Go Red for Women issue. This is to highlight the journal's continuous effort to bring to attention the research which focuses on reduction of sex disparities and enhancing inclusivity in stroke care. This issue of the journal features a number of articles from sex disparities in enrollment in randomized trials of stroke, to sex-related differences in ischemic stroke presentation, outcome of endovascular therapy, plaque composition of carotid stenosis, and the sex-dependent rupture rate of cerebral aneurysms and the risk of subarachnoid hemorrhage, which I encourage you to review in addition to listening to today's podcast. Dr. Negar Asdaghi:         Later in the podcast, I have the distinct honor of interviewing one the leaders in the field of secondary stroke prevention, Dr. Pierre Amarenco from Bichat University in Paris, to discuss the latest analysis of the association between LDL cholesterol levels and intracerebral hemorrhage risk in a sub-analysis of the Treat Stroke to Target trial, and what is next to come on cholesterol-lowering therapies post-ischemic stroke. But first with these two articles. Dr. Negar Asdaghi:         It should come at no surprise to our listeners that the use of marijuana in its variety of forms is increasing not only in the United States, but also across the globe, both for recreational purposes and also for treatment of a range of medical conditions. There's also a growing body of evidence to link marijuana use to cerebrovascular disorders, including ischemic and hemorrhagic strokes. In fact, national surveys in the United States show that over two million Americans with established cardiovascular disorders currently use or report having used marijuana in the past. Dr. Negar Asdaghi:         Aneurysmal subarachnoid hemorrhage is a hemorrhagic stroke subtype that is frequently complicated by cerebral vasospasm and delayed cerebral ischemia, or DCI. Now, we know that development of DCI can significantly increase the neurological morbidity and mortality related to the disease. So, the question is, can marijuana use increase the risk of DCI in subarachnoid hemorrhage? And what is the difference between cannabis and marijuana? And how are they even related to the brain and vascular disorders? Now, to answer these questions, we first have to do a quick review of three key points. Dr. Negar Asdaghi:         Key point number one: The word "cannabis" refers to all products derived from the plant cannabis sativa. This plant contains about 540 chemical substances. The word "marijuana" refers to parts of or products from the plant with substantial amounts of tetrahydrocannabinol, or THC. THC is the active ingredient of marijuana responsible for mediating its psychoactive effects through activation of G protein-coupled cannabinoid receptors, which are easier to remember as CB1 and CB2 receptors. Dr. Negar Asdaghi:         Key point number two: CB1 and CB2 receptors are diffusely expressed throughout the brain, but interestingly, CB1 receptors are also richly expressed across various vascular beds, including the cardiac and cerebral vessels. So, there we have it, a connection between marijuana and the blood vessels. Dr. Negar Asdaghi:         Key point number three: The differential activation of CB1 receptors in cerebral vessels may lead to vasoconstriction or vasodilation, potentially linking marijuana to vasospasm seen in aneurysmal subarachnoid hemorrhage, which then leads to DCI. But it should be noted that THC can also lead to ischemia through other mechanisms, such as altering the brain's oxidative capacity, impairing mitochondrial respiratory chain complexes, and increasing reactive oxygen species in free radicals. So, causing brain ischemia through mechanisms other than vasospasm. Dr. Negar Asdaghi:         So, with these three points in mind, in the current issue of the journal, in the study titled "Cannabis Use and Delayed Cerebral Ischemia After Aneurysmal Subarachnoid Hemorrhage," Dr. Joshua Catapano from the Department of Neurosurgery at the Barrow Neurological Institute and colleagues report on the outcomes of 1,014 aneurysmal subarachnoid hemorrhage patients treated over a 12-year period at their institution from August 2007 to July 2019. Dr. Negar Asdaghi:         The primary exposure was cannabis use, which was detected by routine urine toxicology at the time of hospital presentation with subarachnoid hemorrhage. Patients were also screened for the use of other vasoactive substances, including cocaine, amphetamines, and also tobacco use. The primary outcome was DCI defined as cerebral infarction detected either by CT or MRI or proven on autopsy after exclusion of procedure-related infarctions. Dr. Negar Asdaghi:         And here's what they found. Number one: Overall, 36.2% of their patient population with aneurysmal subarachnoid hemorrhage developed DCI. 50.2% of their total population had poor functional outcome defined as modified Rankin Scale of over two by the time of discharge, and 13.5% died. These are important reminders that aneurysmal subarachnoid hemorrhage remains a deadly form of stroke, despite modern neurosurgical and neurocritical care advances in treatments. Dr. Negar Asdaghi:         Number two: 4.5% of their patient population tested positive for cannabis. And here's the alarming finding of their study. The rate of DCI was significantly higher in those who were positive for cannabis, that was 52%, versus only 35% in those negative for cannabis. This association was not seen with other vasoactive agents such as cocaine and methamphetamine. Now, radiographic vasospasm was also significantly more common in cannabis users, the rate of which was 88% in cannabis users than in non-users, which was 70%. Dr. Negar Asdaghi:         Now, number three: When they adjusted for baseline patient characteristics, presenting Hunt and Hess classification, and other vasoactive substances and active smoking, cannabis use was independently associated with an increased likelihood of development of DCI. So, what did we learn from this study? Active cannabis users were 2.7 times more likely to develop ischemic stroke post-aneurysmal subarachnoid hemorrhage as compared to their non-user counterparts. This is one of the largest studies to potentially link marijuana to development of cerebral ischemia in this population. Dr. Negar Asdaghi:         There is now ample scientific evidence to connect some pregnancy-related complications, such as gestational hypertension, gestational diabetes, preeclampsia, and some pregnancy outcomes, such as preterm birth or having small-for-gestational-age infants, to an increased long-term risk of cerebrovascular events in the mother. Infertility, miscarriage and stillbirth are also common abnormalities in the process of conceiving and being pregnant, but whether there is an association between these abnormalities and development of future vascular disorders in women is not clear. Dr. Negar Asdaghi:         In the current issue of the journal, in the study titled "Infertility, Miscarriage, Stillbirth, and the Risk of Stroke Among Women," Dr. Chen Liang from the School of Public Health at the University of Queensland in Brisbane and colleagues report on the results of a systematic review and meta-analysis on this topic. So, let's dive into it. Dr. Negar Asdaghi:         First, a brief look at their methodology. After a comprehensive literature search, a total of 18 studies were included in this meta-analysis, including over 7,800,000 women between the ages of 23 to 63 with a mean follow-up of 3.8 to 19 years. So, a big study. Five studies evaluated the association between infertility and stroke. Infertility was defined in broad terms as either a formal diagnosis or receiving fertility treatment or testing through databanks or medical records. And the other 13 studies explored the association between a history of either miscarriage and/or stillbirth and the main outcome of the study, which was stroke. Dr. Negar Asdaghi:         In 11 studies, the outcomes of ischemic and hemorrhagic strokes were specified, four studies only reported on the ischemic stroke, and the rest did not identify the stroke subtype. So, what did they find? Well, their first finding was on the association between infertility and stroke. Overall, the five studies included over 4,600,000 women, and this association was inconsistent due to heterogeneity of the results between the different studies. But, when excluding the one study from Asia, which created most of the heterogeneity in results, infertility was indeed found to be associated with a 17% increase in the risk of stroke in the mother. In terms of possible causes, well, they looked at common infertility etiologies and vascular risk factors, and not surprisingly, they found many connecting points. Dr. Negar Asdaghi:         For example, polycystic ovarian syndrome is a common cause of infertility and is frequently associated with insulin resistance and type 2 diabetes. Endometriosis, another cause of infertility, is commonly associated with hyperlipidemia and hypertension as a result of chronic systemic inflammation. Another example is premature ovarian insufficiency that could increase the risk of stroke through elevated follicle-stimulating hormone, a lower level of estrogen, and a relatively elevated level of androgen. Dr. Negar Asdaghi:         So, their next finding was on the association between miscarriage and stillbirth in stroke. As you know, both of these conditions, so miscarriage and stillbirth, describe pregnancy loss at various stages. A stillbirth is the loss of fetus after the 20th week of development while a miscarriage refers to a loss of pregnancy before the 20th week of gestation. Women with a history of miscarriage had a 7% increased risk, and those with a history of stillbirth had a 38% increase in the risk of stroke later in life. Now, since having a miscarriage is a very common occurrence, it's important to pay attention to their dose response sub-analysis. When data was available on the number of miscarriages or number of stillbirths, increased risk of stroke was apparent among women with three or more miscarriages, but not two or less. For stillbirths, similarly, a history of repeated stillbirths was associated with increased risk of stroke, but evidence on association for a single stillbirth with stroke was insufficient. Dr. Negar Asdaghi:         These are important findings to keep in mind when reviewing these results, and importantly, when counseling patients in routine practice. Now, in terms of causes, the authors discuss a variety of associated mechanisms, such as persistent endothelial dysfunction, a common cause for both pregnancy loss and vascular disease, elevated level of homocystine, autoimmune disorders, including presence of antiphospholipid antibodies and a cause for both pregnancy loss and development of arterial stenosis, noting that especially for the autoimmune conditions, specifically in the case of the APS syndrome, pregnancy loss is likely to be repeated, which is consistent with the findings of their subgroup analysis and dose response analysis in the paper, showing that repeated miscarriages and stillbirths are more likely associated with a higher risk of stroke rather than a single event. Dr. Negar Asdaghi:         So, bottom line, what my takeaway from this study is, that many factors that can cause infertility, miscarriage and stillbirth can also cause vascular disorders, and these associations should be kept in mind when treating women at a younger age for fertility and pregnancy-related complications. Dr. Negar Asdaghi:         Intensive therapy to lower serum lipid levels with the use of statins is recommended after transient ischemic attack or ischemic stroke of atherosclerotic origin. Treatment with statins has been shown to reduce the risk of major vascular events in the stroke population, but there remains a concern regarding an increased risk of development of intracranial hemorrhage with this therapy. Whether this increased risk of ICH is a class effect related to treatment with statins, or is associated with a certain low target levels of LDL cholesterol, is uncertain. Dr. Negar Asdaghi:         The Treat Stroke to Target randomized trial tested the hypothesis that a target level of LDL cholesterol of less than 70 milligram per deciliter would be superior to a target range of 90 milligrams to a hundred milligram per deciliter in reducing the overall cardiovascular events after an ischemic stroke or TIA in patients with evidence of atherosclerosis. The primary results of the trial was published in New England Journal of Medicine in early 2020. Dr. Negar Asdaghi:         In the current issue of the journal, in the study titled "Intracranial Hemorrhage in the Treat Stroke to Target Trial," the trial investigators report the results of a pre-specified analysis of the TST trial to evaluate the baseline and on-treatment predictors of incident ICH. I'm joined now by Dr. Pierre Amarenco, who's the first author of the study and one of the primary investigators of the TST trial, to discuss this paper. Dr. Amarenco is an internationally renowned neurologist who absolutely needs no introduction to the Stroke readership, but as always, an introduction is nice. Dr. Negar Asdaghi:         He's a Professor of Neurology and the founder of the Department of Neurology and Stroke Center, as well as the SOS-TIA Clinic, at Bichat University Hospital in Paris. He's a leader in the field of secondary prevention of stroke with special interests in treatment of patients with TIA and mild stroke. He has served as the primary investigator of multiple randomized trials of antithrombotic therapies, lipid modifying agents, and acute revascularization treatments. Dr. Amarenco leads the international TIA registry involving centers from 21 countries around the globe. Welcome to our podcast, Pierre. Thank you so much for joining us all the way from Paris. Dr. Pierre Amarenco:     Good afternoon, Negar. Thank you for asking me. Dr. Negar Asdaghi:         Well, thank you for being here. Let's start with the Treat Stroke to Target trial. It addresses an important gap in the secondary prevention of ischemic stroke literature. Can you please start us off with an overview of the trial? Dr. Pierre Amarenco:     Yes. The objective of Treat Stroke to Target trial was to evaluate in 2,860 patients with ischemic stroke of atherosclerotic origin randomized into a target LDL cholesterol less than 70 milligram or a target LDL cholesterol 90 to 110 milligram per deciliter to see the benefit in the lower target group as compared to the higher target group. That was the purpose of the TST trial. Dr. Negar Asdaghi:         And the trial, Pierre, was terminated early. Do you mind commenting for our listeners as to why this happened? Dr. Pierre Amarenco:     Yes. The TST trial had a very long duration. It was an academic trial with low funding, funded by the French government, which is not quite the same as the NIH-funding trials. To give you an example, patient cost was $1,500 for the whole duration of the trial per patient. Around $1,500 per patient. So, it was a very low funding, and because of that, after nine years, we had to stop. But we had recruited all patients, and we had a three-year follow-up, so we could have a meaningful result. Dr. Negar Asdaghi:         So, perfect. So, just to recap for our listeners: Over eight-year period of time, despite the early termination, you had 2,860 patients enrolled, and so the termination of the trial was administrative reasons alone, as you mentioned. And so what were the primary outcomes of the trial? Dr. Pierre Amarenco:     The primary outcome of the trial was a reduction of 22% in this primary outcome, which was the composite of ischemic stroke and non-stroke, microinfarction, vascular death, and urgent revascularization for coronary or carotid ischemic event. Dr. Negar Asdaghi:         Okay, so the primary outcome was reduction of vascular events, truly, whether cardiac or in the brain. But now coming to the issue that is going to be addressed in your current paper, there remains a concern in the secondary prevention literature regarding an increased risk of intracerebral hemorrhage with statin therapy. Before we talk about the paper again, I want to give us a little bit of a background regarding the roots of this concern. Where does this all stem from? Dr. Pierre Amarenco:     In fact, when you do a meta-analysis of all statin trials, there is no increase of hemorrhagic stroke, particularly trials in primary prevention of stroke. However, in trials in secondary prevention, which include mostly HPS trial with simvastatin and SPARCL trial with atorvastatin, there was a 60% increase in hemorrhagic stroke. That did not outweigh the benefit observed in this trial, but there was a concern about statin in secondary prevention, particularly high dose statin. Dr. Pierre Amarenco:     So, in SPARCL, we did a post-stroke analysis looking at predictors of hemorrhagic stroke, and we found that, as usual, age and male sex increase risk of hemorrhagic stroke, but the most important was uncontrolled hypertension and atorvastatin. Atorvastatin stayed into the model. We know that atorvastatin reduce LDL cholesterol, that low LDL cholesterol in SPARCL was not associated with hemorrhagic stroke. So, there was a paradox because atorvastatin stayed into the model and we know that atorvastatin lower LDL cholesterol importantly. It is possible that something goes wrong between statin and vascular disease in the brain. In SPARCL, we looked at stroke subtypes at the baseline, and we found that atherosclerotic stroke, TIA and cryptogenic stroke were not associated with hemorrhagic stroke. But we found also that patients randomized with brain hemorrhage, 2% of the sample, and patient randomized with lacunar stroke were at increased risk of hemorrhagic stroke. Dr. Pierre Amarenco:     So, altogether, we can say that small vessel disease of ischemic type or hemorrhagic type were associated with hemorrhagic stroke, and we know that small vessel disease is associated with high blood pressure. So, the fact that we found uncontrolled hypertension as a predictor of hemorrhagic stroke in SPARCL was logical since also we found that small vessel disease was a predictor. Dr. Negar Asdaghi:         So, very important points that you mentioned, and I, again, want to repeat them for our listeners. And I think it's one of my questions later on to ask about independent predictors of hemorrhage, but based on the cumulative literature for what we knew before the current study, you had mentioned uncontrolled hypertension, small vessel disease, which is sort of a marker of both ischemic and hemorrhagic events in the brain, were all independent predictors of development of ICH. Whether statin therapy or low target level of LDL adds to that fueling, that fire, or not was something that you wanted to really decipher in the TST trial. I think we're ready to hear about the methodology of your current paper, if you could tell us, please. Dr. Pierre Amarenco:     So, in TST, of course, because of this background, we pre-specified an analysis of incident hemorrhagic stroke. So, we looked at patients with incident hemorrhagic stroke versus those without, and we did a multivariable analysis to look at predictors, and that was the methodology of the paper we use for this specific paper. Dr. Negar Asdaghi:         And what were the primary results? Dr. Pierre Amarenco:     So, the primary result was that after a median of three years follow-up, we found 31 hemorrhagic stroke in the lower target group and 28 hemorrhagic stroke in the higher target group, and the difference was not significant. In the paper, we show a graph with a distribution of hemorrhagic stroke according to the level of LDL cholesterol three months before the hemorrhagic stroke, and it is striking to see that half of the events occurred for an LDL cholesterol above 100 milligram per deciliter and half of the events occurred for an LDL cholesterol below 100 milligram per deciliter. So, clearly, in TST trial, like in SPARCL trial, we did not find a relationship between low LDL cholesterol and incident hemorrhagic stroke. Dr. Negar Asdaghi:         So, very important information for all practicing neurologists and stroke neurologists out there. I want to recap, again, very important numbers that you mentioned. Achieving low LDL cholesterol target, even very low numbers, as you mentioned, was not a predictor of development of intracerebral hemorrhage in the trial. And, as you mentioned, half of them, actually it occurred even before achieving the target LDL for the trial. But you did find some other significant predictors of ICH in the study. Can you please elaborate on those? Dr. Pierre Amarenco:     Yes, we found predictors, and the only predictors we found, in fact, were uncontrolled hypertension, exactly what we found in SPARCL. So, uncontrolled hypertension is really something important, and anticoagulant treatment, which was not found in SPARCL. So they were the only predictors, uncontrolled hypertension and anticoagulant treatment with of use therapeutic implications. When you put patients on a low level of LDL cholesterol, when you target the low level, you have to tightly control blood pressure, which is always a case in secondary prevention of stroke, but particularly when you target the low LDL cholesterol, and then anticoagulant treatment, of course, you have to monitor closely blood pressure and also the level of anticoagulation. Dr. Negar Asdaghi:         So, it's, again, I want to repeat what you mentioned, because it seems like we've been blaming the wrong person all along, concentrating on this issue of statins or low LDL levels being associated or the causative reason for development of intracerebral hemorrhage, and forgetting about the obvious, which is uncontrolled hypertension and now the new finding of being on oral anticoagulants, which is not unexpected. Pierre, my next question was on SPARCL trial, but you've already alluded to the SPARCL study. I'm going to repeat and ask the question regarding SPARCL, because for years and years as practicing neurologists, we've referred to the results of SPARCL, and you already alluded to some of the similarities between the two trials, but is there something else as you compared TST with SPARCL that you want to mention in terms of patient population included in both studies or the differences in the results? Dr. Pierre Amarenco:     The most important difference was that in SPARCL, there was a placebo group, which was not the case in TST since we compared two levels of LDL cholesterol. So, literally all patients were on statins in TST trial, which was not the case in SPARCL since half of the patients were on statins. So, that was the main difference, but the concept of TST clearly came from SPARCL sub-analysis. In SPARCL sub-analysis, we found that achieving an LDL cholesterol less than 70 milligram was associated with a benefit compared to patients with an achieved LDL cholesterol of 100 milligram per deciliter. But that was a post-stroke analysis in SPARCL, and so we had to confirm this, which is why we did the TST trial, which was clearly a follow-up of the SPARCL trial. And then we confirmed what we found in SPARCL, that is low LDL cholesterol was not associated with incident hemorrhagic stroke while there was a benefit of achieving a low LDL cholesterol target compared to a higher target. Dr. Negar Asdaghi:         All right, so just the follow-up question on the LDL levels. Statins are, of course, not the only agent to use to achieve a lower level of LDL cholesterol. There's a growing literature with the PCSK9 inhibitors, especially in patients with acute coronary syndrome, to lower the LDL levels. How are the findings from those studies of PCSK9 inhibitors on the risk of ICH compared to your study? Dr. Pierre Amarenco:     The findings of four-year trial with evolocumab and ODYSSEY OUTCOMES trial with alirocumab was that going to less than 40 milligram per deciliter or even 30 milligram in mean per deciliter in four-year trial was not associated with an increased risk of hemorrhagic stroke. For example, in four year, the risk of hemorrhagic stroke was 0.21% in the evolocumab group versus 0.18% in the placebo group. And in ODYSSEY OUTCOMES trial, it was 0.2% in both groups. So, clearly, going to a very, very low level of LDL cholesterol was not associated with an increased risk of hemorrhagic stroke. To give a comparison, in TST, in the lower target group, we had a 1.25% risk of incident hemorrhagic stroke versus 0.9% in the higher target group. There was a slight increase, but that was not reaching statistical significance, and it was not associated with low LDL cholesterol. Dr. Negar Asdaghi:         Perfect. So, quite reassuring, these results from various trials, again, showing and reassuring that the risk of intracerebral hemorrhage seems to not be significantly associated with lower target levels of LDL cholesterol. Now, we do have time, Pierre, I want to digress a little bit from your current study and ask a question that comes up rather frequently in routine practice. And that is the association between statin therapy, lower levels of LDL and incident ICH in the setting of microbleeds that are found typically incidentally on an MRI study. Do you think there is any possible interaction between the two, or are there plans to look at this as part of TST? Dr. Pierre Amarenco:     Yes. I would like first to say that I don't like the term "microbleeds" or "microbleeding" because it is scary for the patients. I have plenty of patients coming to my outpatient clinic because they are afraid of what they have read on the radiologist report, "microbleeds." "Doctor, my brain is full of microbleeds." I prefer to use the term "microdeposit of hemosiderin," which is descriptive, which is associated with small vessel disease. Dr. Pierre Amarenco:     So, regarding the relationship between microdeposit of hemosiderin and incidence of intracranial hemorrhage on statin, in fact, we don't know the relationship, but we can't say that in SPARCL, there was an association between small vessel disease of hemorrhagic or ischemic type with incident hemorrhage on atorvastatin 80 milligram per day. So, these patients with microdeposits of hemosiderin have small vessel disease, and then they may be at risk of more hemorrhagic stroke. So, in these patients, I would be cautious, and on high dosage of statin. I prefer to use low dosage associated with ezetimibe or with PCSK9 inhibitor to go low for LDL cholesterol, but not with statins. So, this is the way I'm used to do when there is a lot of microdeposit of hemosiderin in my patient, but it has not been tested in clinical trials. Dr. Negar Asdaghi:         So, very important, again, to repeat and recap what you mentioned. First of all, love the term "microdeposit of hemosiderin," and I'm going to use that with my patients. I totally agree with you that telling someone, "Oh, there's tons of blood in your brain," is not quite a good start. But definitely, again, as you mentioned, these are markers of small vessel disease, both for ischemic stroke and hemorrhagic. So, it's important to, again, address the causes of small vessel developments and etiologies very aggressively. And, as you mentioned, the jury's still out whether the statin class affect an association with incident ICH or an association between low target levels of LDL cholesterol, and more to come on that in the future. Pierre, just to end our podcast, what would be your top two takeaway messages for our listeners on the topic of target LDL and incident ICH? Dr. Pierre Amarenco:     Well, the message is simple. Targeting an LDL cholesterol of less than 70 milligram per deciliter in atherosclerotic ischemic stroke non-significantly increases the risk of subsequent intracranial hemorrhage. Incident intracranial hemorrhage were not associated with low LDL cholesterol level. And we found two predictors of incident intracranial hemorrhage, which were uncontrolled hypertension and anticoagulant therapy, which has important clinical implication for our patients. Dr. Negar Asdaghi:         Dr. Pierre Amarenco, it's been a pleasure interviewing you on the podcast today, and we look forward to having you back with more on this topic. Dr. Negar Asdaghi:         And this concludes our podcast for the February 2022 issue of Stroke. Please don't forget to check out this month's table of contents for the full list of publications, including a series of Focused Updates on vascular brain health organized by Dr. Steve Greenberg. Dr. Negar Asdaghi:         February is also a special month for our stroke community, with our annual International Stroke Conference, which this year is held as a hybrid event, both face-to-face in New Orleans and simultaneously as a virtual event for those who cannot attend it in person, as the fight against the COVID-19 pandemic continues. Reminding us all that with every challenge, there comes new ways to live, to cope, and to rise above it all. And we're here to do just that with staying alert with Stroke Alert. Dr. Negar Asdaghi:         This program is copyright of the American Heart Association, 2022. The opinions expressed by speakers in this podcast are their own and not necessarily those of the editors or of the American Heart Association. For more, visit AHAjournals.org.  

Dr. Jason Tarpley, MD, Ph.D. is the Director of the Stroke Center at Providence Saint John's Health Center and directs the Pacific Stroke and Neurovascular Center. His focus is treating patients with ischemic and hemorrhagic stroke and intracranial vascular lesions such as aneurysms or arteriovenous malformations. He is also trained in neuroendovascular therapy to treat these patients. You can read more about Dr. Kaiser at the link below https://www.pacificneuroscienceinstitute.org/people/jason-tarpley/

Conversation with Shannon Burton, ACNP, SCRN, Nurse Practitioner, Stroke Center, MedStar Washington Hospital Center & Lee Stroy, stroke survivor and Ambassador, American Heart Association/American Stroke Association, about causes/risk factors, signs/ symptoms, and treatments for a stroke; also recovery, rehabilitation, and prevention.

Health Matters is a weekly radio show sponsored by the Medicine Center Pharmacy on WHBC 1480 AM in Canton, Ohio. This episode pharmacists Brad White and Paul White discuss Stroke Awareness Month with Maria Griffin, APRN-CNP, coordinator for Cleveland Clinic Mercy Hospital’s Stroke Center. Topics will include risk factors, warning signs, preventive measures, treatment options and statistics related to stroke.   http://www.medshoprx.com  http://cantonmercy.org  

On New Mexico in Focus… The Asian American community held a rally in downtown Albuquerque this week in response to an increase in violent and harassing incidents across the state. That surge mirrors what is happening all over the country in the wake of charged and divisive language about the COVID-19 virus. It was just about two weeks ago that eight people were killed, six of them females of Asian descent, in a mass shooting in Atlanta, Georgia. Police officials were reticent from the start to call the shootings a hate crime. Host Gene Grant talks with members of the local Asian American/Pacific Islander community about how bad things have gotten here in New Mexico, and what can be done to turn the tide. Diversity has also been a huge challenge for years when it comes to local news coverage. Those concerns include not only the diversity of faces that deliver the news, but also the types of stories that are told. Gene Grant recently sat down with Albuquerque’s first African American president and general manager at a major news station, Lori Waldon of KOAT-TV. The two talk about the importance of who tells our stories and what those stories say about our communities. Gene Grant also sits down with three people at the center of a major development on the local public health front. The University of New Mexico Hospital was recently certified as the state’s first comprehensive stroke center. They discuss how this new designation will lead to faster and effective treatment for stroke patients, not just in Albuquerque, but across New Mexico. Host: Gene Grant No Line Opinion Panel Segments: Rise of Asian American/Pacific Islander Violence Host: Gene Grant Guests: Kristelle Siarza, volunteer executive director, Asian Business Collaborative Sachi Watase, executive director, New Mexico Asian Family Center Diversity in the Local Media Landscape Host: Gene Grant Guest: Lori Waldon, general manager and president, KOAT-TV UNM Hospital’s Comprehensive Stroke Center Host: Gene Grant Guests: Andrew Carlson, MD, neurosurgeon Torsten Rohde, RN, director of UNMH Stroke and Heart Failure Programs Michael Torbey, MD, chair of the UNM Department of Neurology

EMS A to Z: Stroke Screening Scores Show Notes: From your hosts, Dr. Josh Gaither, Dr. Amber Rice, and Dr. Rachel Munn Follow your Stroke Administrative Guideline! If a stroke is suspected, first perform a Cincinnati Prehospital Screening Scale: If positive perform a VAN. VAN positive Greater than 4 hours of symptom onset: transport to Comprehensive Stroke Center (Banner UMC or TMC). Within 4 hours of symptom onset: transport to nearest Stroke Center (patient may still be tPA candidate). VAN negative Transport to the nearest Stroke Center. See this reference from CoreEM for performing a VAN screen. Don't forget to consider and evaluate for stroke mimics (like hypoglycemia).  

Over the past decade, numerous advances have been made in the treatment of stroke patients. During that time, stroke center designations have evolved. Designating bodies across the US generally recognize four stroke center levels. These four levels have been created in collaboration with the American Heart Association and American Stroke Association. Starting with the highest level of care, they include:Comprehensive stroke centers Thrombectomy capable stroke centersPrimary stroke centersAcute stroke ready hospitalsIn this episode, we sit down with two stroke experts from Ascension Providence Rochester Hospital. Dr. John Whapham, MD, MS, FAAN, FSNIS, the Medical Director of Neuro Interventional Surgery, and Amanda Kalinsky, MS, AGACNP-BC, RN, CCRN, Nurse Practitioner and the Stroke and Neuroscience Program Manager. They are here to discuss what it takes for a hospital to advance its stroke center capabilities and designation. Specifically, their hospital is going through the process advancing from a Primary designation to a Thrombectomy Capable Stroke Center designation. Both guests have experience with advancing a hospitals stroke center designation. They are currently completing the process of advancing from a Primary designation to a Thrombectomy Capable Stroke Center designation. They’ll help us appreciate what it takes for a hospital to advance their stroke center certification. In addition, they’ll give us their opinion on the use of stroke severity scales by EMS to identify and measure potential strokes. Finally, we list and describe key things that every EMS crew should consider each time they encounter a potential stroke patient. Visit EMSonAIR.com for the latest information, podcast episodes and other details. Follow us on Instagram @EMSOnAIR.Please keep emailing your questions, comments, feedback and episode ideas to the EMS on AIR Podcast team by email at QI@OCMCA.org. Support the show (https://www.patreon.com/emsonair?fan_landing=true)

NATIONAL STROKE AWARENESS MONTH   Special guest: DR. CAROLYN BROCKINGTON Carolyn D. Brockington, MD is the Director of the Stroke Center at Mount Sinai St. Luke’s and Mount Sinai West Hospital in New York City. She is board certified by the American Board of Psychiatry and Neurology and has a subspecialty board certification in Vascular Neurology.  In addition, she works with the American Stroke Association (ASA), as a volunteer medical spokesperson, regarding a campaign to increase stroke awareness and highlight prevention strategies, particularly in young adults. She was named one of “New York’s Best Doctors” by New York magazine in 2003 and has written several articles about stroke related issues. 

Eric Rieger  Alright, we're going to get down to the gut check project starting on episode 34. It's gonna be a quick one, but you're gonna love it.Ken Brown  Yeah, we're gonna try and do this a little bit quicker because what I've gotten some feedback is when you guys get all sciency that sometimes it's it's cool to hear the fun stuff, but the reality is that the science gets a little geeky and it gets almost like a lecture. So I apologize to everyone out there if I've been some weird professor but so my only thing so let's do the personal stuff is your family good? Eric Rieger  Family's Great! Awesome. Ken Brown  My family's great also awesome. And that's up for the personal stuff. So like I said, I was called by a good friend, Tim, our good friend his father had... Eric Rieger  Tim Power been on the show. Ken Brown  Yeah, Tim power been on the show. His father had a stroke. And he messaged me and he said, Hey, man, my dad had a stroke, and they don't seem to be talking diet. They don't seem to talking supplements. He's in rehab. He's getting better. I'm doing my own stuff. I'm trying to fix this. But do you have any recommendations? And rather than just knee jerk and go, Oh, I'm going to go ahead and yeah, just do this and this and this. I started thinking about it. I went Holy cow, my hospital. Medical city Plano.Eric Rieger  Right. Ken Brown  Is a level one trauma center and is designated as a magnet hospital for stroke, acute stroke rehabilitation. Eric Rieger  Okay. Ken Brown  So they have a whole team that if you show up with a stroke, it's just like a heart attack. They're badass. Yeah, they show up with like this team of interventional neurologists, and they get in there and they do all this stuff. So I'm sitting there. My quick side note, I'm picking up my family from Mexico, because Luke was just playing tennis. You know, that was the the personal part of it that we didn't get into, but just assume it's tennis. Eric Rieger  Assume it's basketball.Ken Brown  Yeah. So I called. I called the stroke rehab unit. And I spoke with them with the nurse. The manager, nurse and she was so cool. She's like, She's like, hey, yeah, blah blah blah Yeah, we were our rates are this. This is the protocol. I'm like, what's a protocol for diet? We don't have one. What's protocol for supplements? We don't have one  i'm like, Oh my goodness, let's look at this. So I called our secret weapon. And I started to get into it and it's a much bigger bite to chew off then we can do in this sort of quick episode. So this quick episode, I want to just focus on the endocannabinoid system and stroke. Because what we do with stroke victims is that we basically do everything wrong. Eric Rieger  I believe it. Ken Brown  In the hospital. Eric Rieger  Yeah. Ken Brown  And when I asked him, like, what is the typical diet? She's like low fat. Eric Rieger  What's the science behind that? Ken Brown  Exactly. And we know that the carbohydrates increase inflammation and this and that. I'm like, Well, what else and she's like you had traditionally everybody gets put on a Staten, which causes some brain inflammation, because we're chasing numbers on cholesterol. Anyways, keep listening, because we're going to end up doing another episode on we're going to develop a protocol that I hope everybody adapts, and the nurse was like, that would be amazing. nobody's talking like that. Because everybody has this hammer. I mean, we bring these people in, they have a stroke. And one of the most important things is sleep and what do we do just disrupt sleep, check vitals blood sugar, and all this other stuff. So basically, we focus up we focus on all this stuff. So I called a couple neurologists, and was like, Hey, man, what's the or Hey, woman? I don't want to be sexist here. I'm like, Hey, what are we doing here? What's going on with the you guys are crushing it. So basically they focus on the awesomeness science of clotbusters like tpas and blood thinners. And then they rush in with this incredible technology that is amazing. Where they get in and they do like cardiac clot, like the same thing that the cardiologists have been doing. That they end up just sort of extracting these clots and they just crazy stuff. It works, but then they don't think about anything else,. So here a gut check project. I feel like we check our egos at the door and we look and go, how can we do things a little bit better? I feel like that this conversation that we're having could be the beginning of something bigger. Sure. I feel like we're missing a ton of stuff. This is not to bash traditional medicine at all. This is just a glorious example of how medicine save lives. But unfortunately, if all you have is a hammer then everything's a nail. So we're going to go ahead and look at that today. Eric Rieger  Let's do it. Ken Brown  I'm gonna do one brief thing. Because we always do in in the news, we always do our personal lives in the news, mostly because it's a win for me. So I'm just whenever I find news that is pertinent to me, I'll talk about it. And I'll just kind of, like most people just sort of ignore the stuff that bothers you. Bottom line is a study just came out. Looking at coffee. Eric Rieger  Oh, I love coffee. Ken Brown  So February is Heart Month, right? Eric Rieger  It is. Ken Brown  So everyone talks about Heart Month, and we're strokes are almost parallel to heart. So the same vessels that can ruin your brain can ruin your heart. You're gonna die either way. Let's start fixing it. Eric Rieger  Yeah. Ken Brown  So a study came out this last Thursday. So just a few days ago, in a journal called PLOS biology that I follow, which always looks at like new and upcoming research, as it find it. As it turns out, we know that coffee is good in 2017. There was this big meta analysis that show that help with diabetes. And also helped with cardiovascular disease and different things like that. But we really never, we always thought it was the polyphenols. So these guys looked at this and they took mouse models. And what they showed is that the caffeine plays a role. Eric Rieger  Nice. Ken Brown  Yeah. In case you haven't guessed that I drink just tons of coffee. Eric Rieger  I didn't have to guess I see it all the time. Ken Brown  Alright, so anyways, they took mouse models, and what they showed is that when you drink four to five cups of coffee equivalent in caffeine, you actually improve the mitochondria in the heart cells. They even show that the mitochondria is that you know, it's the powerhouse of the cell. It's what makes you walk around. It's what drives every single cell they found a protein called p 27, which is stimulated by caffeine. And when they gave heart attacks to mice, and then they gave them coffee, the mice that got the coffee, or the caffeine equivalent, recovered quicker, knockout mice that they took away the P 27 protein or whatever, they all died of heart attacks. So quick little thing in the news, coffee good, helps diabetes helps heart disease. And now we realize that it improves mitochondria. So I got to thinking and I was like, wow, the whole mitochondria is our aging thing. I found an article where they looked at old an aging mice, the more caffeine that they took in during the day, the more that their mitochondria were younger, and it was an anti aging molecule. So polyphenols plus caffeine, it looks like.Eric Rieger  it's really interesting, brief note, and maybe we should even do a show about caffeine and the systemic effects because during anesthesia school, we talked about why caffeine does what it does, and the jitters. And essentially, the way it was explained to us and shown to us is that they didn't know the exact mechanism, but they could tell that the threshold that it took for like a neuron to fire was lessened. So what it does is it lowers threshold to elicit an action potential. It would make sense that somebody who's a little bit older, basically you're taking down the barrier. And now you've got demand making the mitochondria useful. I mean, it's...Ken Brown  Yeah, I like where you're going with that.Eric Rieger  It's all kind of systemic, we'll get to that. That sounds like a an interesting... Ken Brown  So that's just basically in the news Heart Month now we're doing this... Eric Rieger  And if you think this episode's fast, wait til we do the caffeine one.Ken Brown  So this is just one of those things where we're, we're trying some different stuff out but one of the biggest problems I had is I called the stroke center and they do not have a protocol. And then when I called the neurologists and and I said one thing I was like, have you guys ever thought about the endocannabinoid system, in your specialty.Eric Rieger  No, they haven't.Ken Brown  Not only No, it was a hard no with that BS. Eric Rieger  Sure. Yeah. Ken Brown  So rather than get an argument and like, we'll just do a show on it.Eric Rieger  Yeah, we will. Ken Brown  So this show should be titled the anti bs side of endocannabinoid system and stroke. Eric Rieger  Let's do it. Ken Brown  Alright. So, once again, geeky sorry, we've done two geeky shows in a row. We're gonna have to start having, you know, just playful things. We have to have a comedian on like Joe Rogan or something like that.Eric Rieger  Eventually.Ken Brown  Yeah. It's probably a little premature. Alright, so let's talk about the endocannabinoid system really quick. I'm gonna throw it to you, and I'm gonna let you just to describe to everybody what is the endocannabinoid system. Eric Rieger  The best application that we know today that I understand is it basically functions as a great communicator, between our nervous and our immune system. So you have these two systems and basically it functions as the regulator. It's the one that prevents one from being overstimulated and driving the other one to do something that you don't want it to do.Eric Rieger  100% So the way that I describe it to my patients, our endocannabinoid system is like any other system in our body, you have a cardiovascular and neurologic. The endocannabinoid system works like a traffic cop. And what it does is it says we need more inflammation here. Whoa, you're overreacting. Why don't you just calm down right over here? So keep that in mind, because as we talked about the endocannabinoid system, now we're going to talk about how does the endocannabinoid system relate to stroke. So unfortunately, we got to talk a little bit about strokes. And I like history you like history. So, Hippocrates, the father of medicine first recognized strokes over 2400 years ago, we got 2400 years to figure out how to fix this. At that time, they called it apo Plexi, which means struck down by violence. So 2400 years and to this day stroke still kill 140,000 Americans. That's one out of every 20 deaths. Eric Rieger  Wow. Ken Brown  Someone in the United States has a stroke every 40 seconds. That means every four minutes someone dies. Every year more than seven Well, let's just call it 800,000 people in the United States have a stroke. About 87% of all strokes are ischemic stroke. Which means it's decrease of blood flow. And $34 billion are lost every single year due to strokes. Stroke is a leading cause of serious long term disability, stroke reduces mobility in more than half of stroke survivors. So the, if the actual death is not shocking enough. It's your health span is reduced. And you and I always talk about lifespan versus health span...be healthy. So what I'm going to talk about right here is crazy that this is not being implicated. This is not are not implicated not not being used in the traditional sense.Eric Rieger  Gotcha. Eric Rieger  All right. So, right now, the cool science going on is that we've got all this intervention, we got labs, we got stroke centers. We did we're, I feel like we can do a whole episode on just the diet, the supplements, everything around lifestyle on a stroke. And we're going to do that just like we're gonna do the butyrate episode coming up and just like we're going to do, every time we get into a topic, we start digging deeper, and we learn a little bit more. So today, the fact that these neurologists are saying, oh, food is Bs, well, I'm just taking on the big 600 pound gorilla. I want to say, Well, I want to know what you're not even thinking about endocannabinoids are you? And they're like, that's really bs. Now we're gonna get into it. So it is there's tons of research in the animal model of how to target so this topic of this podcast is the endocannabinoid system and strokes. Holy cow, there's tons of data on this and we're not even talking about it. I'm at a, a world class Stroke Center. Where we save more people than like anyplace else. We've been given national recognition. If if you're the CEO of who owns our house, the old colombia The HCA HCA if you're the CEO of HCA, pay attention because I can say more people for you, because as it turns out, there's lots of confusing data out there. And I took the time to go ahead and look at some of this. It's really cool. Basically, we've already reviewed the endocannabinoid system. Now in this endocannabinoid system, there's two primary receptors. We're learning that there's more for the Wil Clydens of the world that are super smart, and they understand that there's a lot more than that or the Chris Kressors and people like that. But for the general public, there's two receptors, cb one and CB two, there are the traffic cops, right? So that's what we have to realize. So as we alter the endocannabinoid system through different things, we know that the endocannabinoid system is associated with Parkinson's disease. It's associated with Alzheimer's and multiple sclerosis. The only drug approved is epidiolex for seizures. This is part of the problem. It's the confusion of what's going on? People say what does the FDA say? Well, did you know that the FDA just missed their mark to present to Congress on February 20? No? Ken Brown  Yeah, they missed it. That's another news article. They did not come up with a consensus statement on CBD when they were mandated by Congress to do that, because everybody's so confused. Eric Rieger  Wow, you know, I didn't know that we should look into that.Ken Brown  And we know that in those studies of epidiolex, there was 86% side effects and all the things. So what I'm going to get into is the full spectrum, what we're looking at here, so stick with me here I know that I'm kind of bouncing around. What I'm trying to do is set the stage that the endocannabinoid system is intricately related to the disease known as a stroke or the event known as a stroke. So knowing that the endocannabinoid system is important in Parkinson's and in Alzheimer's, dementia and such like that, what we want to try and figure out is how is the endocannabinoid system related to similar things which is Parkinson's and dementia are inflammation in the brain. Well, the stroke is immediate inflammation. Alright, so CB one receptors. I say this only because the argument will come up will be like, well, I found some studies that showed that there were some studies looking at CB one receptors were when you had knockout mice, they did better. Other studies show that they did worse. Some said that this and that. And so I was going through all this literature going, this is silly. This is we don't really have a conclusion. So the bottom line is, think of it this way. And I will use a Will Klyden quote, it is a symphony. It is not one instrument. When you are looking at the endocannabinoid system, if you are just going to focus on one thing, which unfortunately researchers do because it's impossible to account for all the other variables, all I can say is CB one is intricately involved and it may be involved in a negative way. When it becomes a stroke. So if Your endocannabinoid system is not in tune. It can make it worse. Just like a symphony where you have the brass section which is just screwing it up. You've got the rest of the symphony playing Mozart and you've got some other people just kicking some cake. Eric Rieger  An orchestra with only symbols is not very entertaining. Ken Brown  No, it's not. So I bring this up because when you start trying to read it and debate it and look at it, you can be thrown curveballs. One of them is that and, but then you dig deeper. And there's all this literature on this instrument called CB two. Cb two is the other instrument, cb one, cb two are the two receptors. Now we're learning more about the endocannabinoid system, the data is much more straightforward on this. Basically, multiple rat models have shown that when you give an agonist or a CB two activator, both pre stroke and post stroke you decrease the amount of damage, so you can actually prevent what's going to happen. And then once it happens, you go, Oh, we need to stimulate that. Keep that in mind. Because to prove a point further, when CB two was blocked, the rats had tremendously more damage and they had residual effects. So just by saying the endocannabinoid system, and they're like, oh, it involves CB one, cb two, which is the top level that everybody talks about. The interplay is way more, you gotta let the body do what it wants to do. can't shut one off, you can't turn one on. You can't encourage you have to be able to let the body do what it wants to do.Eric Rieger  No, definitely. And that's, that's really not that different than lots of different drugs which they thought they pulled them out of racemic mixtures. And then what racemic mixture means is you've got two different variations of the same molecule and one's active and one isn't But then they learned that sometimes if you do one and try to isolate it, you actually caused damage. Whereas before, if you had them together, you didn't have that damage. And it's played that multiple times.Ken Brown  So clearly CB two receptors play a very key role. What I'm trying to prove here is that when we take these animals and we mess with these receptors, we either increase the damage or we decrease the damage. So the theory is that the endocannabinoid mediated modulation of the inflammatory process is the reason why people get better. So in other words, we always talk about inflammation. Now they're realizing that the CB two receptor mitigates the inflammatory process during an ischemic event. Eric Rieger  That's pretty important. Ken Brown  It's really wild. So now what actually interacts with these receptors? So if somebody's never heard these terms before, they're like, man, they're talking weird stuff. They're talking CB one, cb two, don't worry about that. Cb one, cb two are just two likeminded things that are trying to make you better. As it turns out, we can say this about every single system in the body there's going to be interactions, downplaying in the gastrointestinal system. Histamine will stimulate a cell which will produce gastrin, which will increase the acid production blah, blah, blah, we know this Eric Rieger  But histamine could, the same molecule on a different receptor could cause a completely different Ken Brown  100%. So why would the endocannabinoid system not be different than every other system? Eric Rieger  It's it sounds to me like it's very normal. Ken Brown  You know what I keep saying? We're gonna have Endocannabinoid ologists I'm gonna be the first endocannabinologist. I'm gonna get myself a title. So somebody had to be the first black belt or something. I mean, why don't I just rushed to be like? I'm It! I'm it! Eric Rieger  I'm the BBECS. Ken Brown  Yeah. Alright, so there's two endocannabinoids. What I mean is you make your own CBD. And those two things there's we're learning that there's lots of them. But for the basics it's anandamide and 2ag. So knowing that you have these two endogenous meaning two endocannabinoids that stimulate CB one and CB two now we're just learning what they do. Okay. So 2ag goes up dramatically following a stroke.Eric Rieger  So trying to do some damage control.Ken Brown  We don't know...Eric Rieger  We don't know...Ken Brown  We do know that when anandamide is the soft light that is always on when you go through a stressful event 2ag turns on switch the flashlight. So the feeling is that that 2ag is the fight or flight Endocannabinoid. Eric Rieger  Oh, okay. Ken Brown  Yeah, so when you need it, It ramps way up. In situations where there's cell damage, it doesn't know the difference that there's cell damage possibly it's ramping up because it's like we're in fight or flight mode. We're dying here. Eric Rieger  Where's the inflammation? Ken Brown  Yeah, so these guys are postulating that when you block 2AG, the stroke damages less. My feeling is well, what if it's doing something someplace else? Like, what if you needed that 2ag burst? So when you have fight or flight, you need it for different things. Sure. Some people would say, oh, you're having a fighter flight. You're being chased by a saber toothed Tiger your blood pressure's up. We should give you blood pressure medicine. No, it's the right thing that should be happening right now. Yeah, I need the blood pressure to pump the blood. So we know that that to ag is your fight or flight Endocannabinoid think of it that way the flashlight Anandamide is the one that you want up, that is the Eric Rieger  Parasympathetic, your rest and digest. Ken Brown  It's the it's not quite the parasympathetic one, but it's the one that is your baseline that should always be filled, that anandamide tank should always be filled. 2aG. We're gonna learn more about it in the future because we haven't studied that as much. But when you have 2ag around, blood flow gets reduced. So the damage is worse. And this is really interesting because when your baseline anandamide is low, your 2 a G will overshoot. Eric Rieger  Okay.Ken Brown  So they work like a seesaw. So if you can get them in balance, we always talked about balance and in sync. When your anadamide is full and your 2ag is full, they never really mess with each other. In a situation where you're depleted in your endocannabinoid system, then you will have the propensity to have too much 2Ag and your anandamide is in fight or flight and your endocannabinoids will keep producing the two AJ, Eric Rieger  That is very, very interesting. So in other words, what we want is to never be in a position where our our ECS is low on what it needs to function. Ken Brown  100% so anandamide we're now learning is probably the baseline Endocannabinoid that controls the day to day response that you're having. 2ag turns on when you need it to turn on. So, although the animal models show that 2ag increases significantly causes vasoconstriction and all this stuff, we're learning that okay, maybe, maybe this is my theory, the stress and the chronic disease. Listen to this one more time here, the stress and the chronic disease that led to a stroke. Meant that your anandamide was being depleted and your body was getting ready for the event. You're 2ag going up. So stress, lack of sleep, diet, all have been shown to decrease our anandamide levels, stress, lack of sleep and diet have all been shown to be linked to cardiac and stroke and every other event that we talked about Eric Rieger  Time and time again. Ken Brown  So when I grab a neurologist and I say, Have you ever thought about the endocannabinoid system, the religious stroke and they're like, that's BS. I'm being nice about how they said it to me. Are you kidding me? Eric Rieger  Well, it's...Ken Brown  we're missing this huge, giant piece.Eric Rieger  It's kind of sad because the research isn't it's not one paper. This is it's ubiquitous, it grows every single day. I think people have over the last 50 years have forgotten that innovation brought us to where we are now. I mean, we used to not have TPA we used to not have kumudin and we used to not have these things I mean it those were also new introductive things for us to figure out.Ken Brown  I was talking to somebody yesterday and they were like you know what's really skewed when you look back at like the the average lifespan when you when you factor out the deaths at birth people still live to like 60 and 70. Like, like, but there was so many things that killed babies Eric Rieger  Oh, you mean long ago, Ken Brown  Like long ago. So when I say that Hippocrates was describing strokes, and you know, 2000 years ago, whatever. But this is so fascinating because think about this, if you keep your anandamide levels optimal like adding Atrantil which blocks an enzyme that breaks down your own anandamide levels. That is something that we can look at, and I think that's part of the next episode. But when you take CBD, so our CBD product here, when you take a good quality CBD it doesn't even bind directly to CB one or CB two. We know that a full spectrum product has many cannabinoids and other molecules that bind to certain receptors. We also believe that CBD will play a role in helping the body to produce more of its own Endocannabinoids. So what I tell my patients is that if you take CBD, you're going to increase your own anandamide levels. You take CBD plus Atrantil, That's the signature package and you're going to make sure that you block the enzyme that breaks down your anandamide Eric Rieger  So it lasts longer. Ken Brown  So it lasts longer and the neurologists like there's no science in this. Okay? So I had to dig deeper, or our secret weapon dug deeper for me. In rat models, infusing CBD into the brains of rats significantly helped to decrease the amount of damage and help recover in stroke. Really CBD does nothing? They actually injected CBD into the brains of rats that they cause strokes. And it actually blocked the ischemic event. One to One. Crazy! Eric Rieger  That's noticeable. That's a reproducible event.Ken Brown  Then in another study, they showed that the blood brain barrier sealed its tight junction and decreased brain swelling post stroke when you gave them CBD, Eric Rieger  Which is huge. I mean, I know it sounds really, really technical, but trust me, that's not nothing.Ken Brown  Remember the whole reason that I'm even talking about this is because our friend Tim just called me and said, Hey, man, my dad's in rehab, and they're not saying anything. Well, it was shown that continued oral administration post stroke at one week, and one month reduced the volume of infarct and improved neuro behavior on autopsy. So they're taking this it showed that CBD reduced white matter injury reduced glial response, meaning that the cells did not react to it. And it increased BDNF.Eric Rieger  Which is what you need for repair.Ken Brown  You need that for repair. Shit! This is nuts. Yeah, we're over here saying that CBD isn't do anything where the endocannabinoid doesn't have it and I'm finding article after article and these guys are finding amazing data BDNF. If I the first thing I would do would be to the first thing I would do would be to put people we're going to come up with a whole protocol. And I'm gonna go to HCA and don't be like, everybody that has a frickin stroke needs ABCD and one of them's gonna be frickin CBD. This is ridiculous.Eric Rieger  We've got some opportunity, though. And not everybody's closed, we could probably find a couple of neurologists around here in the area that are at least willing to fairly examine data and dive in. And that's what we'll have to do.Ken Brown  We're gonna end up having to go into this. I mean, the fact that I called my own Stroke Center, and the nurse sheepishly said, Well, you know, they do the usual things that put them on a low fat diet, and I stopped her. Which, by the way, it's really cool, because when I called up, I was picking Lucas up and I was like, yeah, hey, it was nurse manager. And she's like, Yeah, and I said, I said, Yeah, this is, this is Dr. Brown. Do you have moment to ask couple questions. She's like, sure what patient is that? Regarding? I'm like, now I just wanna ask some questions. And she stopped. She goes the GI Doctor said, Yeah, she's like, oh, like, what do you mean uh Oh, she's like, I've seen your show. I'm a little scared what you're gonna ask. I'm like alright and so that's how we got this talk. So right now new models are looking at immediate administration of CBD and hyperthermia. So somebody out there is saying, if we make them cold and give them CBD, and it seems to be a synergistic effect Eric Rieger  Wasn't that long ago, people thought that making the body cold was a bunch of Hocus Pocus crap, too, right? It really wasn't that long ago. And so now we've returned to its natural element, all we're doing is reducing body temperature. But however long ago it was, I can remember people saying, Well, you know, they're trying the cryo, and at first like, hey, maybe it works. And then suddenly, we saw lack of decrease in loss of neural function, you know, make believers.Ken Brown  So I want to play devil's advocate, and we talked last time that we're going to do some sort of like contest. Here's the contest, for the listeners. All right. There is a reference when I was looking at all this stuff, one reference, there was an article on stroke in cannabis ingestion, where they said that cannabis ingestion increases the incidence of stroke. So and then I went and found the article and realized there's a lot of other factors associated with that, much like the FDA article that we did on liver failure. It's very much like that. But the FDA is using an article like that and ignoring everything that I just said. And they're using that. So what I propose is and you figured out, you're the you're the techie guy, let's do some sort of giveaway where if somebody the first person that messages us in one way or another email, Instagram, Facebook,Eric Rieger  Paul we're gonna need help with that, Ken Brown  yeah, snail mail, whatever, I don't know. That references the article and puts the author's names down because the author's names you'll you'll really, you'll You'll definitely find the article when you find this author's names, that I think we should give them a signature package Eric Rieger  Signature package if you find the well hidden, gem about marijuana, cannabis smoking and stroke causation, right? Ken Brown  Yeah. So spoiler alert. So I'm going through a whole Rick and Morty Phase I should do.Eric Rieger  If you're not watching Rick and Morty, that's one way to decrease anxiety.Ken Brown  All right.Eric Rieger  This episode is brought to you by Rick and Morty.Ken Brown  I cannot believe it's took me this long to find that show I am I come home and that's 20 minutes of just complete giggle time, just total giggle time. Alright, so lots of cool animal data. I just explained what I think shows that the endocannabinoid system is intricately related to strokes and how we can improve it and in some ways if you try and mess with it, make it worse. Eric Rieger  So let's I know we did a quick episode but let's just do a quick rundown to make sure that everybody who's listening or watching can make their own crib notes. So, essentially, before and after a stroke, you can prepare your body for better recovery or prevention of the stroke itself that comes from having a healthy endocannabinoid system your ECS. How can you fortify your ECS? You make sure that you have enough sleep, you make certain that your diet is rich in polyphenols, which of course you can supplement with altrantil, and you make certain that you have the correct macronutrients for your ECS to lift up which you can get with a formidable or reputable CBD which kbmd health has both of those things. So in essence, if you want you don't know how you're going to get hurt, a lot of people don't know that they're going to have a heart attack today had a patient today. 172 poundsKen Brown  I thought you were gonna say 172 years old and I was like wowEric Rieger  Six foot one Well built man. 172 pounds 49 years old, has been doing jujitsu and Taekwondo for 30 something years. Heart Attack had a heart attack back in 2012. Undiagnosed cad, the guy's got, which is coronary artery disease, the guy has two stents in. My point is, nobody knows you don't know when you're going to be susceptible to something. So if you can, he was doing what he could, right he was exercising. So he was doing that part, right, but maybe something else that he could have been aware of...Ken Brown  I'm telling you, we're going to learn that the endocannabinoid system plays a much bigger role in this and we have seen diseases start happening earlier and all that stuff. Eric Rieger  KBMD health GCP code GCP save 20% on your signature package. Ken Brown  100%. So the bottom line is that there's tons of supporting evidence that exists for the involvement of the endocannabinoid system and the pathology of a stroke. Now clearly, this is super complex and we're just getting into it. And these researchers that are coming up with conflicting data about trying to block CB one or trying to agonize CB two, don't, don't do that what we really need to do is just make sure let your body do what it wants to do, when there is sufficient anandamide, which is the one that we know really kind of helps out, it will work like a traffic cop and keep the receptors in check. 2ag is probably necessary for certain things. So if we're doing this show, and you start to well, like I'm like, okay, bottom line is if I'm looking at you, and you're talking to me, and all of a sudden you start slurring your speech and half your face starts drooping. Yeah, you look like you're having a stroke. First thing I'm going to do is run and grab a whole bottle of KBMD CBD and I'm gonna shove it down your throat because at least we know in animal models, that makes a big difference. And then I'm going to go get a bunch of other supplements that we're going to do a whole nother show on that should be protocol for every single stroke center in the US. So much like the butyrate podcast, we got another one that we're getting into and I'm gonna bring a neurologist on and I want to bring an expert so that we can talk about it Eric Rieger  Small request, if I'm having a stroke and you're going to do all that CBD also get a speech pathologist to make sure I can swallow.Ken Brown  Yes, we will do all that if you're having a stroke, but I'm not trying to be a jerk about this, but we're going to finish the show first.Eric Rieger  Cool.Ken Brown  So, I mean, if it starts happening, try to do it towards the tail end of the show. You know, do you know that I've had four heart attacks since we've started this. This whole podcast show but I just suck it up, move on. I've had all kinds of health issues.Eric Rieger  That Believe it or not is going to go down to the books is our first short episode. Ken Brown  Well, we want to do a short episode because I feel like we're getting a little too sciency and I want your feedback. I mean, quite honestly, do you like the science you not like the science? Do you want the guest? Do you not want the guest? But when I find stuff like this, I have to let it out. And if you gave me Two hours, I'd be talking for two hours. So this is just a way to control the amount of vomit that I do right here. But it's so cool. How are we not doing this? Eric Rieger  I don't know. But I think I think will change though. And thanks every single week and thanks to Paul. we're gaining viewers. We're gaining listeners. This last week was a huge spike in the last seven shows. So thank you.Ken Brown  And you want to know what people are reaching out on their Insta they're messaging me on Instagram and they're asking medical questions. I love that I'm we're going to do shows on that stuff. So if you've got questions, let's do this. Eric Rieger  Definitely. that's gonna do it for episode number 34. That was strokes and the endocannabinoid system. We will in the show notes, go ahead and add unrefined bakery, their offer is still good. So save 20% if you want to have keto friendly, no gluten, paleo friendly, whatever kind of meal that you're after, and you feel like you can't have bread, they've got the solution for you unrefinedbakery.com use code, gutcheck and save 20% Ken Brown  Yeah,so once again, please do us a big favor. What we're trying to do is really spread this message of functional health. share it with everybody, get people calling in, get people asking because we've got the resources. we're gaining a little bit of traction here and this can be really fun. This was such an eye opener for me. Endocannabinoid system and strokes. All because somebody said my dad had a stroke Ken Brown  and Tim power thanks for reaching out. certainly appreciate it. gut check project. In the books go to gut check project. com share, like and share and we appreciate it.

Dr. French talks about the important information we need to understand to recognize stroke symptoms, to reduce our chances for a stroke, and other related topics.

According to the Stroke Center, stroke is the leading cause of serious, long-term disability in the United States. Approximately 795,000 people suffer a stroke each year. Three out of four stroke patients don't receive treatment fast enough for the best chance of a full recovery. Listen as Dr. John Cullen discusses the life-saving stroke care provided at Rochester Regional Health.

It’s been another busy week for us here at Science Today. During a visit at the University of Calfornia, San Francisco, we learned that about 10 to 25 thousand cases of stroke, aneurysm or epilepsy may go undetected each year. Anthony Kim, director of UCSF’s Stroke Center has been studying misclassified cases of neurological death, which were erroneously thought to be sudden cardiac death. "So, it has kind of implications on the public health estimates, it has implications on the interpretations of death outcomes, in large cardiovascular trials." And it also has implications on diagnosis. And while on the subject of diagnosis – the rates of childhood asthma and allergies are on the rise in this country, so if you want to lessen your child’s risk, you may want to consider getting a dog. Susan Lynch, a gastroenterologist at UCSF made this connection while studying microbes in newborn babies’ bodies. "Exposure in early life to a greater breadth of organisms seems to be beneficial and allows the system to accumulate a greater diversity of organisms, which really means a greater diversity of the microbial functions." In other words, a mixture of home dust and a dog’s dander can help a child become immune to asthma later in life, especially if the pet is brought home when a child is no older than one month. And finally, we crossed the bridge into Berkeley to speak with a cognitive neuroscientist there, who has found that language and memory are actually interconnected. Robert Knight says for decades linguists were ignoring this fact and studying these two brain functions separately. "One of our areas of research is defining the degree of that connectivity; how the brain rhythms in one area, the hippocampus, are coherent with brain rhythms in the language area, like two people dancing. Are they in synch, right? Are they coherent?" To hear these and other episodes about the latest University of California research, tune into Science Today on iTunes or follow us on Soundcloud. Thanks for listening, I’m Larissa Branin. Subscribe to Science Today: iTunes: apple.co/1TQBewD Stitcher: www.stitcher.com/podcast/science-today Follow us on Facebook: www.facebook.com/ucsciencetoday Stories mentioned in this roundup: https://soundcloud.com/sciencetoday/stroke_detection https://soundcloud.com/sciencetoday/kids_asthma https://soundcloud.com/sciencetoday/language_memory

Radio show host, Gary Calligas will have Alan Little, MD, Medical Director of Stroke Center at WKHS Pierremont on his Saturday, May 7th The Best of Times Radio Hour at 9:05 AM on News Radio 710 KEEL to explain strokes, learn ways to prevent a stroke, become aware of the warning signs of stroke symptoms, and learn the latest in treatments. You can also listen to this radio talk show streaming LIVE on the internet at www.710KEEL.com. For more information, please visit these websites at www.thebestoftimesnews.com andwww.hebertstandc.com. This radio show is proudly presented by Heberts Town and Country of Shreveport featuring Dodge, Chrysler, Ram, and Jeep vehicles and service.

Many people people believe that strokes are an inevitable consequence of aging or that only the elderly suffer from them. That's not true, says Dr. Michael Frankel of the Stroke Center at Grady Memorial Hospital. Learn your risk.

Many people people believe that strokes are an inevitable consequence of aging or that only the elderly suffer from them. That's not true, says Dr. Michael Frankel of the Stroke Center at Grady Memorial Hospital. Learn your risk.

Dr. Michael Frankel of the Stroke Center at Grady Memorial Hospital on recognizing the signs of stroke and knowing how to respond -- and save lives.

Dr. Michael Frankel of the Stroke Center at Grady Memorial Hospital on recognizing the signs of stroke and knowing how to respond -- and save lives.