Stroke: The Basics
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- Опубликовано: 16 июн 2024
- Stroke: The Basics
Understanding stroke is important to its prevention and rapid treatment. The Stanford Stroke Center has pioneered major advances in medical therapies for treating and preventing stroke, innovative neurosurgical techniques for stroke prevention and ground-breaking interventional neuroradiologic procedures. This talk covers these topics and more.
Speaker: Gregory W. Albers, MD Director, Stanford Stroke Center and Coyote Foundation Professor of Neurology and Neurological Sciences, Stanford University School of Medicine
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The willingness and ability to explain medical concepts in layman terms with such clarify is a gift
17 year post ischemic stroke at 42. Left side hemipatisis. I have never stopped trying to recover.i can walk short distance with a cane.never give up.
unless you have rosacea and your medication won't allow you to have a rhinophyma-type operation ..All due to Blood thinners and Blood pressure medcation
This is a criminal act.
@Henry Louden Nnjjju
Never you should give up. Good luck
@Henry Louden Be aa no aA B a a BGC a as a
Fantastic speaker! I had my stroke 3 years ago.
David Kane do you want a cookie?
Eddie W what a horrible thing to say.
I hope you are better now...
Another reason that universal healthcare could help pay for itself. Paying for doctor's visits and high blood pressure medication could prevent extremely high costs of lost productivity, and care for stroke victims. Our current system says, "I won't help you pay for oil changes, but I'll pay to help you replace your engine when it blows up because you haven't changed your oil."
I fall between the cracks so I am uninsured, and I recently had a stroke. Luckily it was relatively mild, but my hospitalization would have been unnecessary if there had been an easy path for me to receive blood pressure medication and affordable doctor's visits.
Father in law had a ischemic stroke on Tuesday. Found him 30 minutes later. Anti clot measures all worked but was curious on recovery phases. This is good.
thank you .. the best lecture of stroke ! 👌👌
Excellent. Thank you very much. 🌟🌟🌟🌟🌟
woah. im a 14 year old girl in germany and i really want to become a surgeon when im older. the lecturer gave me an impression on how lectures in med school actually work. thanks! now i kinda wanna go to med school abroad -maybe in the usa or canada.
Hahaha me too I’m 15 and I want to be a cardiologist and this was pretty interesting
13, and I want to be a neurosurgeon or cardiothoracic surgeon.
I hope you all 3 follow 5hrough with your dreams- there is always roomfor committed medical professionals.
Such a clear lecture. It was a pleasure to listen. Thank you!
I was told I have had at least 6 rare types of strokes…from vasculitis…team of doctors…they didn’t know how to treat it and make them stop…The worst was chemo….didn’t help. One doc found (on the internet) studies in France for pills they were using with success. My strokes stopped, but, the losses already happened. Another patient showed up near me with my conditions. He was given the pills. He’s fully recovered. Doctor apologizes for not finding the pills sooner for me. Could some form of pill be given for folks with the indicators? My early symptoms….double vision, light headache, numbness, exhaustion….Thanks for your video to help explain what happens. One doc told me I was one in a million and the stuff that case studies are made of. Lucky me. 🤕🤯
Very informative. Thanks
great lecture.
I guess I am the only one who wants to see the pace of lectures in Med Uni, because I am applying... I hope to be a surgeon.
Anyone who had a stroke, stay healthy. Hope you are doing well now.
You can do it!! 🙌🙌🙌🙌🙌
Haha 😂 you are the only one. I’m not applying for college in 5 years.
As a student nurse heading to an acute stroke ward for my first placement, I found this very informative.
I would have liked the doctor to discuss foods that help the heart keep healthy, that lower blood pressure, and help to avoid strokes. Otherwise, very good lecture, I just happened on the video on RUclips and thought the subject Interesting.
Exactly right. Nutritional information is severely lacking in relation to medical conditions and statins are promoted whilst underplaying the side effects - particularly for women - as so many of us are increasingly evidencing.
Normalize blood pressure with magnesium taurate and body weight management , decrease sticky blood with omega 3 oil, ginkgo biloba, vitamin e, garlic. There are a lot of ways to prevent problems.
Thanks for posting! I was given TPA within 3 hours of my stroke, initially it work fully but after an hour the symptoms of my stroke came back within an hour, Why?? It's been just over 3 weeks now from being bedridden to talking with a little help with a cane but limping.
I am scared of strokes and have anxiety about it and about my health. I don't know why this helped😅
Knowledge is Power.
Very prolific informations. Thank you so so much Doctor.
Sdssdddssd ßsdssssßs
Excellent talk John
I wish i saw this as a med student
Very informative thank you
Very good information 👌
Very interesting.
Very lucid presentation
Thank you for the great lecture. I did notice that at the time you drafted this lecture it appears that the NOACs didn't exist such as rivaroxaban, eliquis... and also it seems since you drafted this lecture that aspirin is not recommended any more as a stroke prevention and/or treatment.
Excellent enjoyed 😉👍
aspirin does work
Aspirin does work
I've been taking aspirin though I had a stroke I had other problems like Type 2 diabetes and irregular heart rate
I'm now 3 weeks into my stroke my left arm is not functioning but left leg is slowly recovering
Thank you a patient my self thank god for life
My stroke was sheer bad luck - a piece of unstable plaque broke free and got stuck in a stenosis in my middle cerebral artery damaging my right basal ganglia.
thank you!
Can you please help me I am a 49 year old man who has had a stroke
Can anybody tell me where can I watch similar videos?
Keep searching in Google, they have many 😊
Hello my name is Anthony and I suffered from a TBI back in 2010 and suffered a CSF leak as a result and ever since then I get horrible headaches when exerting myself along with neck pain and I feel worse as the day goes in and I occasionally get clear runny fluid out of my nose. They did go up my nose and patch a hole in my dura back in 2010 but I’m afraid the leak has come back and would love to have your assistance
Hello doctor i am amjad from pakistan my mother was suffer in stroke last of 6 years so i want your this treatment for my mom can you tell me your all hospitalization and medication charges thank you plz help
How long does a patient who had stroke due to a blood clot need to stay on medication? I been hearing different opinions from different doctors some said life long some said 6 months some said 1 year. Why is the opinion so divided? Please could you clarify, thank you.
🎯 Key Takeaways for quick navigation:
00:00 🧠 *Introduction and Background of Stanford Stroke Center*
- Introduced to the basics of stroke and the talk's focus on prevention and treatment.
- Overview of the speaker's career at Stanford and the formation of the Stanford Stroke Center in 1992.
- Emphasis on collaborative efforts among neurology, neurosurgery, and radiology for comprehensive stroke care.
02:30 📊 *Stroke Overview: Prevalence and Impact*
- Stroke as the fourth leading cause of death, with a focus on its disabling effects.
- Shift in stroke demographics due to aging populations.
- Anticipation of a significant increase in stroke cases over the next two decades.
04:36 💼 *Personal Impact of Stroke and Comprehensive Stroke Center Accreditation*
- Personal touchpoints with stroke in everyday life.
- Accreditation of Stanford Stroke Center as a Comprehensive Stroke Center.
- Importance of collaboration and comprehensive care in stroke treatment.
06:38 📚 *Defining Stroke: Types and Causes*
- Definition of stroke as a brain injury from a sudden disruption of blood flow.
- Distinction between ischemic strokes (clot-related) and hemorrhagic strokes (bleeding).
- Discussion on the causes of hemorrhagic strokes, including aneurysms and high blood pressure.
08:41 🧊 *Anatomy of Stroke: Blood Vessel Systems*
- Overview of the carotid and vertebral arteries, their roles, and accessibility.
- Introduction to the Circle of Willis and collateral circulation.
- The influence of anatomy on stroke symptoms and severity.
14:33 ⚙️ *Symptoms and Anatomy: Left Carotid Artery Blockage*
- Discussion on symptoms arising from left carotid artery blockage.
- Emphasis on language issues, numbness, and vision problems.
- The impact of abrupt onset and the challenges in recognizing symptoms.
18:04 🔄 *Symptoms and Anatomy: Right Hemisphere Stroke*
- Overview of symptoms resulting from right hemisphere stroke.
- Neglect phenomenon, confusion, and lack of self-awareness in right-side weakness.
- The subtleties and challenges in identifying right hemisphere stroke symptoms.
19:31 🚥 *Symptoms and Anatomy: Posterior Circulation Stroke*
- Exploration of symptoms related to posterior circulation stroke.
- Varied presentations, including double vision, vertigo, and coordination issues.
- The complexity of diagnosing posterior circulation strokes.
20:55 🚑 *Recognizing Stroke Symptoms and Causes*
- Reiteration of key stroke symptoms: language trouble, weakness, numbness, and headache.
- Identification of atherosclerosis as the primary cause of blood clot-related strokes.
- Encouragement for prompt action, emphasizing the importance of calling 911.
21:23 🧠 *Stroke Causes: Atherosclerosis and Embolism*
- Atherosclerosis is the primary cause of strokes, occurring in the blood vessels, particularly in the aortic arch, carotid artery, and brain vessels.
- Atherosclerosis can lead to plaque formation, mainly consisting of cholesterol, which may rupture and cause a blood clot.
- Atrial fibrillation, a heart condition, can also lead to embolisms, where clots form in the heart and travel to the brain, increasing the risk of strokes.
23:13 🎥 *Progression of Atherosclerosis*
- Atherosclerosis is a gradual process involving the buildup of cholesterol plaques on blood vessel walls.
- The plaque, initially containing cholesterol, may rupture the endothelium, leading to clot formation.
- As atherosclerosis progresses, blood flow can be restricted, causing a plumbing problem and eventually leading to stroke.
27:48 💊 *Stroke Prevention: Risk Factors and Control*
- Smoking, alcohol abuse, and physical inactivity are significant risk factors for strokes.
- Controlling blood pressure is crucial, as high blood pressure is a prevalent and powerful risk factor for both atherosclerosis and bleeding in the brain.
- Cholesterol management, particularly with statin medications, plays a vital role in reducing stroke risk.
29:33 ⚠️ *Transient Ischemic Attack (TIA) and Immediate Action*
- TIAs are brief episodes with stroke-like symptoms caused by a temporary blood clot in the brain.
- TIAs indicate a 5% risk of a stroke within the next two days, emphasizing the need for immediate medical attention.
- Controlling blood pressure significantly reduces stroke risk, emphasizing the importance of managing treatable risk factors.
37:30 🩸 *Blood Thinners and Treatment Options*
- Blood-thinning medications, such as aspirin and anticoagulants, are used to prevent blood clot formation.
- In cases of atrial fibrillation or significant heart conditions, stronger anticoagulants may be necessary.
- Surgical options like carotid endarterectomy or carotid stenting are considered for plaque removal and improved blood flow.
41:10 🚑 *Stroke Treatment: Tissue Plasminogen Activator (TPA)*
- TPA (tissue plasminogen activator) is a clot-dissolving medication used to treat strokes caused by blood clots.
- Administered within a limited timeframe (usually three hours), TPA aims to dissolve the clot and improve blood flow, reducing the extent of brain damage.
- The effectiveness of TPA depends on factors like clot size, duration of blockage, and collateral blood flow.
42:45 🚑 *Stroke Treatment Window*
- The FDA-approved treatment window for TPA (clot-dissolving medication) is three hours from the onset of stroke symptoms.
- Challenges arise when patients arrive more than two hours after symptom onset, as crucial brain imaging and tests take time, limiting the treatment window.
44:23 🧠 *Penumbral Imaging and Extended Treatment*
- Penumbral imaging, using MRI techniques like diffusion imaging, helps identify salvageable brain tissue even beyond the FDA-approved three-hour window.
- Stanford's study demonstrated benefits of TPA up to six hours for patients with a large salvageable penumbra, challenging the standard treatment timeline.
46:09 🌀 *Mechanical Clot Retrieval Devices*
- The Mercy Retriever, a mechanical clot retrieval device, is approved by the FDA for extracting clots from the brain.
- The catheter-based retrieval process involves navigating a corkscrew-like device into the clot, with advancements beyond the initial model.
47:31 📊 *Case Study: Time-Critical Treatment*
- A case study illustrates the critical importance of prompt stroke recognition and intervention.
- A patient with sudden left-sided paralysis, treated promptly with clot removal, showcased significant recovery.
51:02 🔄 *Challenges with Fixed Treatment Windows*
- Discussing the limitation of fixed treatment windows based on time and the variability in individual responses.
- Highlighting the need for more personalized approaches, considering factors like collaterals and advanced imaging, rather than relying solely on time constraints.
52:11 🌐 *Individual Variability and Imaging*
- Addressing the challenges of arbitrary time windows and the importance of considering individual brain characteristics through sophisticated imaging.
- Emphasizing the ongoing research to establish more nuanced and personalized approaches for stroke treatment.
56:26 🩹 *Blood Pressure and Stroke Risk*
- Exploring the dual role of blood pressure-too high contributing to stroke and too low potentially causing ischemic optic neuropathy.
- Highlighting the importance of managing blood pressure and discussing the potential risks associated with extremely low blood pressure.
59:47 💊 *TPA Accessibility and ER Readiness*
- Explaining the evolution of ER readiness, with many hospitals in the Bay Area becoming primary stroke centers, equipped with TPA.
- Reflecting on the transformation from a time when stroke patients were low priority to the current readiness of most ERs in the region.
01:00:01 🕰️ *TPA Administration Process*
- Clarifying the typical method of TPA administration, primarily through intravenous infusion.
- Mentioning situations where direct administration into the clot through a catheter might be necessary, offering additional insight into the process.
01:02:25 🔄 *New Anticoagulants vs. Coumadin*
- Discussing the advantages of new anticoagulants over Coumadin, particularly for atrial fibrillation patients.
- Addressing the ease of regulation and reduced need for frequent blood tests associated with the newer anticoagulants.
01:03:56 🧪 *Omega-3 and Statins*
- Touching upon the controversy surrounding omega-3 supplements and emphasizing the stronger evidence supporting statins for stroke prevention.
- Highlighting the guidelines that recommend statins over omega-3 supplements based on available evidence.
01:04:23 🔄 *Monitoring New Anticoagulants*
- Discussing the challenges associated with monitoring the levels of new anticoagulants compared to Coumadin.
- Explaining the smoother regulation and convenience offered by new anticoagulants, despite limitations in direct monitoring.
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Very greatly appreciated, thank you so much 🙏
Can thick blood coz a sroke?
Yes
I really need the midecation..pls help me how.
Call 911.
Did I understand you to say that more strokes happen a night ? If so why ? Hypertension runs in my family .
Because they eat so much carbohydrates and they probably eat corn oil, soy,canola oil. Or any Hydrogenated oils. And they are insulant resistance to death.
My NAMI IS JASMINE JAVIER FACEBOOK BUT TRIPOLI I HAD HAD A STROKE SINCE LAST FEBRUARY 2018 MY SLUR IS SLOW 5 MONTS JUNE 6, 2018. SO MY RIGHT SIDE WENT PARALYZED MY LOW SPEECH IS LOW BUT I WANT TO WALK
so sorry to hear that Jasmine I wish you a speedy recovery
Nice nice 😊
I had two haemmorhagic strokes in 1969...I was 4 and a half in Burbank California. I had two ruptured aneurysms.:CVa. All the lectures I hear on internet tell that SAH happens to old people. Not true. In America, back in '84 20% of the ruptured aneurysms affected 20 years and younger. By the way, to this day (I am 55) all the neurologists( L.A. France and now Israel) neurologists ask me: Do you smoke? the answer is: no, and never did. My cholesterol is good. When you have a SAH at the age of 4and a half, you don't smoke.
My Mother to and shes young she had hémorragie becouse of high blood prusser and you is it becouse of that to ?
blessed soul..
What caused the plavix to make my body cold and turn blue
Stroke in Africa;painful no care at young age,pls invent cure or medicine 4paralysis
Where dos the blood clot start?
excess plant carbohydrate, plant oils, and exogenous inflammation causes blood clots. Humans by nature are carnivores, we cannot survive without meat. But many people are eating junk plant foods like Soda and french fries. Beans, rice, grains are not healthier because it still spikes your blood sugar and causes diabetes which lead to stroke. The healthiest diet is an all meat carnivore diet because we are not different from lions and tigers.
At 28 minutes he says "Alcohol can cause a heart rhythm problem." Well, alcohol is sugar.
Why not say sugars cause heart rhythm problem? And diet is 90% of the problem.
Alcohols and sugars are two completely distinct molecular structures and chemical classes. Do not mix them. Sugars cause heart problems, and hence stroke, through sedentary lifestyle, neglect, ignorance, weight gain and diabetes.
An alcohol will contain a hydroxyl group as part of the functional group bound to a carbon being part of an aliphatic stem. Sugars are saccharides, mono- or disaccharides, which contains a hydroxyl groups supported by chiral carbon atoms. The saccharides appear in cyclic- og acyclic forms, the latter may with an untrained eye resemble an alcohol acyclic in the skeletal structure definition.
The breakdown is different. Ethanol (drinking alcohol) breaks down through a 2-step enzyme degradation process catalyzed by alcohol- and aldehyde dehydrogenase (ethanol - acetaldehyde - acetate).
Sugars are broken down through another process.. Firstly the starch (polysaccharides are split) is broken down (i.e. glycogenolysis) by separate enzyme before being utilized in the glycolysis for generation of further metabolic substrate.
@@larsskattebl773 Wine is alcohol but is Keto friendly. I dont think wine causes stroke, but still causes liver damage. Stroke is caused by getting too much calories from Plant foods in the form of starch, sugar and Plant oils like soybean oil. Humans by nature are obligate carnivores, our natural prey is ruminant mammalion herbivores.
herbal supplement? What? How to get?
I had one and my doctor told me blood clot came out so much then it goes back
Awesome lecture. The questions at the end made me cringe
Ich hatte 1969 zwei haemmorhagische Schlaganfälle ... Ich war viereinhalb Jahre in Burbank, Kalifornien. Ich hatte zwei gebrochene Aneurysmen. Alle Vorträge, die ich im Internet höre, sagen, dass SAH alten Menschen passiert. Nicht wahr. In Amerika waren 1984 20% der gebrochenen Aneurysmen 20 Jahre und jünger betroffen. Übrigens fragen mich bis heute (ich bin 55) alle Neurologen (LA Frankreich und jetzt Israel): Rauchen Sie? Die Antwort lautet: Nein und hat es nie getan. Mein Cholesterin ist gut. Wenn Sie im Alter von viereinhalb Jahren eine SAH haben, rauchen Sie nicht.
I was born too early. Man I totally would have gone into neuroscience
OK I am going to say this once. Many things can exacerbate a stroke such as birth control, smoking and bad genetics. But the root cause is 100% Dietary. If you had a stroke, blame your diet. Humans are carnivores in nature because we cannot survive without meat in the wild but we can survive without eating any plantfoods. Stroke is caused by getting too much of your calories from plant foods in the form of starch, sugar, high fructose corn syrup, and Plant Oils like soybean and corn oil. No mammalian species eat that, including herbivores. Herbivores have gut bacteria that can convert plant fiber into animal fat and animal proteins. This is why cows eat grass all day long but are not made of grass. But force sugar on them and they will die early (including from stroke) All animals eat a diet high in animal calories. Ask yourself this, would you feed what you have been eating in the past decade to any wild animals like tigers, monkeys, pandas, and gorillas? Humans are really no different.
The best comment on this vid. A keto diet where all the food is clean is the best approach to stroke. This guy is just pushing pills. 6 years ago a had bypass surgery and a pacemaker put in, 5 years ago went LOW CARB best decision of my life.
Well said! I agree 100%!
And all of that happened at "The big bang" randomly? LOL
Chinese acupuncture is cheap and effective treatment
Amazing lesson I really enjoyed it but idk why he’s smiling while saying very sad things it’s kinda scary bro
He's just very passionate about his expertise
Cholesterol is in your entire circulatory system. Why is there clogging of the ARTERIES close to the heart and not in the veins or capillaries in your nose, ear or knee?
This is because the pumping of the heart can cause hairline cracks. Blood pressure is highest in this area. These hairline cracks are repaired by a sticky substance LP(a), to prevent from getting worse.
Why don't animals have cardiovascular disease?
Almost all animals produce large amounts of vitamin C in their liver.
On average 35 mg/kg body weight. So we have to take at least about 3000 mg of vitamin C ourselves because humans cannot make vitamin C. You get strong collagen tissue, strong connective tissue, strong arteries. Hairline cracks no longer form and arterial plaque is removed and burned in the liver.
Repair with cholesterol is therefore a consequence of a deficiency of vitamin C.
So do not take statins, but vitamin C in a high dose: at least 3 grams, better: 6 to 10 grams
Source: Cardiovascular disease and vitamin C (Dr. Rath Foundation)
was the lecture given to taxi drivers, they are continuously guessing wrong answers
I don't know what you mean????
🤣
Think legalization of cannabis will increase the number for strokes? The smoke would increase LDL cholesterol & also raise blood pressure, which would increase the number of both ruptured and blocked arteries.
Oh shit,,, Yeah I woke up and could not move and it has happened 2 times. I thought it was sleep paralysis... 19:12 may be another stroke I had , Oh crap Ah zoo
Steve. Enyrr8
Nb
Sleepy class
Gun Control by Frank Suarez - RUclips
Statin drugs are dangerous
So many incompetent health care "professionals"
Carnivore diet. Problem solved.
Statin drugs are dangerous; do not delete my post.
Another chronic lifestyle disease. The poor rats dying due to stupid humanity.
great lecture.
Iii