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There has been tremendous progress in recent decades in the management of ischemic strokes. Meanwhile, hemorrhagic strokes have stubbornly resisted this progress. Interventions for these types of strokes have failed again and again to show a benefit over standard medical management, until this year. The recently published ENRICH trial is the first to show that minimally invasive neurosurgery may improve functional outcomes for patients with hemorrhagic stroke. Study lead author, Dr. Gustavo Pradilla joins us today to talk about the differences between ENRICH and previous negative trials, and future neurosurgical approaches for spontaneous intracerebral hemorrhage. Dr. Pradilla is a Professor of Neurosurgery, Otolaryngology, and Head and Neck Surgery at Emory University School of Medicine and Chief of Neurosurgery at Grady Memorial Hospital. He spoke to Dr. Masoom J. Desai, neurointensivist and Assistant Professor of Neurology at the University of New Mexico. Series 5, Episode 9
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Guest: Dr. Gustavo Pradilla, Emory University School of Medicine & Grady Memorial Hospital Interviewer: Dr. Masoom Desai, University of New Mexico -
2024 has been a year of exciting trials on minimally invasive techniques in intracranial hemorrhage. This month we're focusing on Chronic Subdural Hematoma, where a minimally invasive strategy called Middle Meningeal Artery (MMA) Embolization is offering expanded treatment options for select patients. Dr. Chris Kellner is a cerebrovascular neurosurgeon and associate professor of neurosurgery at Mount Sinai. He'll talk about the promise of MMA embolization with Dr. Sarah Nelson, neurointensivist and neurohospitalist at Tufts Medical Center. We'll have more on these trials on the podcast in our June episode as well, with a focus next month on Minimally Invasive Techniques in Spontaneous Intracerebral Hemorrhage. Series 5, Episode 8
Featuring:
Guest: Dr. Chris Kellner, a cerebrovascular neurosurgeon from Mount Sinai Interviewer: Dr. Sarah Nelson, a neurointensivist and neurohospitalist at Tufts Medical Center Disclosures: Dr. Kellner is the PI for two studies discussed during the podcast funding was received from Medtronic and Cerenovus. -
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Football fans may remember in January 2023 when Damar Hamlin, a player for the Buffalo Bills, suffered a cardiac arrest and collapsed on the field during a game on live television. He had a remarkable neurologic recovery, prompting us to focus our podcast that month on the need to avoid nihilism when we prognosticate after cardiac arrest. But what is the right balance between pessimism and optimism? Today, we'll hear from Dr. Karen Hirsch, neuro intensivist and associate professor of neurology at Stanford, about finding the Goldilocks zone in neuro prognostication after cardiac arrest. Dr. Hirsch was interviewed by Dr. Sarah Stern-Nezer, vascular neurologist and neuro intensivist at UC Irvine. Series 5, Episode 7
Featuring:
Guest: Dr. Karen Hirsch, Stanford Health Care Interviewer: Dr. Sara Stern-Nezer, University of California, Irvine Disclosures: None -
Glioblastoma is the most common malignant brain tumor and one of the most aggressive solid tumors. Much progress has been made in the understanding and classification of gliomas, but progress in terms of prolonging survival has been limited. Several recent investigational therapies are bringing new hope. Our guest today is Dr. Eric Wong from Brown University. He is an international expert on advanced treatments for glioblastoma and a Professor of Medicine, Radiation Oncology, Neurosurgery, and Neurology at Brown University. He was interviewed by Dr. Christoph Stretz, a Vascular and Critical Care neurologist at Brown. Series 5, Episode 6
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Guest: Dr. Eric Wong, Brown University Interviewer: Dr. Christoph Stretz, Brown University -
Brain death is one of the most controversial and ethically complex topics in neurology, but it's a regular part of our clinical practice. Late last year, a new set of guidelines was published that address some of the thorniest technical and ethical issues in the clinical determination of brain death. For this discussion, we are joined by Dr. Ariane Lewis, a professor in the departments of Neurology and Neurosurgery, as well as the director of the Division of Neurocritical Care at NYU Langone Medical Center, and Dr. Matthew Kirschen, an assistant professor of Anesthesiology and Critical Care at the hospital of the University of Pennsylvania and the Children's Hospital of Philadelphia. They were interviewed by Dr. Masoom Desai of the University of New Mexico. Series 5, Episode 5
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Guests: Dr. Ariane Lewis & Dr. Matthew Kirschen Interviewer: Dr. Masoom Desai Disclosures: None -
Small fiber neuropathy is one of those conditions in neurology that can feel frustratingly intangible. Even for patients with severe neuropathic pain and autonomic symptoms, in about half of cases, the usual lab testing doesn't reveal a cause. There's increasing evidence that autoimmunity may be a factor in some of these cases of idiopathic small fiber neuropathy, but how to test and who to treat with immunosuppression is less clear. Our guest today, Anne Louise Oaklander, is an Associate Professor of Neurology at Massachusetts General Hospital and an Assistant in Neuropathology. She's known for her work on small fiber neuropathies and in this episode we'll talk about new autoantibodies associated with small fiber neuropathy and where we are in treating this challenging condition. Series 5, Episode 4
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Guest: Dr. Anne Louise Oaklander Interviewer: Dr. Adeline Goss Disclosures: None -
The recent FDA approval of lecanemab, an amyloid-sequestering agent, has been hailed as a breakthrough in the treatment of Alzheimer disease. Critics of the drug have pointed to its cost, risks, and treatment burden. Now that lecanemab is being administered in clinics across the country - how is it changing the lives of people with Alzheimers and their families? Dr. Megan Richie, neurohospitalist at UCSF, spoke to Dr. Seth A. Gale, Co-Director of the Brain Health Program and Assistant Professor of Neurology at Harvard Medical School. Dr. Gale has been involved in creating the clinical program that is delivering lecanemab to patients at Brigham and Women’s Hospital and Massachusetts General Hospital, with the first patients receiving the drug this month. Series 5, Episode 3
Featuring:
Guest: Seth A. Gale, MD - Co-Director of the Brain Health Program, and Assistant Professor of Neurology at Harvard Medical School Interviewer: Megan Richie, MD - Neurohospitalist at UCSF and Chair of the ANA Education Innovation Committee Disclosures: Dr. Gale disclosed that he is a site Principal Investigator or Sub-Investigator (at Brigham and Women's Hospital) for several clinical trials in Alzheimer disease. Sponsors for those studies include Biogen, Eisai, Roche, Genentech, and Eli Lilly. I am on a scientific advisory board for MindAhead DE, with the opportunity for honoraria. -
Chronic pain can be incredibly challenging -- for patients, of course, and also for their physicians. On this episode of ANA investigates, Dr. Adeline Goss talks to Dr. Prasad Shirvalkar of UCSF about a new possible strategy for treating chronic pain: deep brain stimulation. Series 5, Episode 2
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Guest: Dr. Prasad Shirvalkar of UCSF Interviewer: Dr. Adeline Goss Disclosures: Dr. Shirvalkar disclosed that Medtronic Inc, donated devices for research, but no direct financial support -
The brain and its vasculature used to be considered separate domains. But in the last decade, we’ve learned more about the interplay between brain cells and vascular cells. Pathological studies are revealing a surprising degree of overlap between cerebrovascular disease and neurodegenerative disease. All of this has led to the coining of a new word: the neurovasculome. Our guest today is Dr. Eric Smith, an author of a recent scientific statement about the neurovasculome in the journal Stroke. Dr. Smith is a Professor of Neurology, Radiology, and Community Health Sciences at the University of Calgary, and the holder of the endowed Katthy Taylor Chair in Vascular Dementia. He was interviewed about the neurovasculome by Dr. Christoph Stretz, a Vascular and Critical Care neurologist at the Warren Alpert Medical School of Brown University. Series 5, Episode 1
Featuring:
Guest: Eric Edward Smith, MD, MPH, FRCPC, FAHA, University of Calgary Interviewer: Christoph Stretz, MD, Brown University Disclosures: Dr. Smith disclosed that he receives personal consulting fees from Alnylam Pharmaceuticals and Eli Lilly -
As the ANA's 2023 Annual Meeting comes to a close, we wanted to catch up with Frances Jensen Chair of the Department of Neurology at University of Pennsylvania and outgoing President of the ANA, and Rebecca Gottesman, Stroke Branch Chief of the National Institute of Neurological Disorders and Stroke and outgoing Chair of the Annual Meeting Planning Committee. Listen as these two leaders chat about the cutting-edge research, exciting sessions, and broader themes that have defined this year's meeting in Philadelphia.
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A growing body of research suggests that people with insomnia are at higher risk of stroke. Listen today as we dive into how sleep health, stroke, and the nervous system all have an affect on each other. Series 4, Episode 11 Featuring:
Guest: Dr. .Sonja Schuetz, University of Michigan Interviewer: Dr. Joseph Carerra, University of Michigan Disclosures: Dr. Schuetz reports funding from contracts between University of Michigan and Oura Health Ltd., Huxley Medical Inc., and Apple Inc. -
Lysosomal storage diseases are progressive, inherited disorders of metabolism, many with devastating effects on the nervous system. Some of these diseases, like Infantile-Onset Pompe disease, can be treated to some degree in childhood by giving back the missing enzyme - a strategy called enzyme replacement therapy, or ERT. But a recent study reported in the New England Journal of Medicine goes a step farther -- by giving enzyme replacement therapy to a fetus with Pompe disease, for the first time, in an attempt to treat the disease before it does any serious damage. The paper’s first author is Dr. Jennifer Cohen, a Pediatric Medical Genetics Physician-Scientist at Duke University Health System. During this episode, she’ll walk us through the potential benefits of in-utero enzyme replacement therapy and other cutting-edge approaches to treating genetic neurologic conditions. A relatively new field called fetal therapy. Dr. Cohen was interviewed by Dr. Adeline Goss, the host of ANA Investigates. Series 4, Episode 10
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Guest: Dr. Jennifer Cohen, Duke University Health System Interviewer: Dr. Adeline Goss, Highland Hospital Disclosures: Dr. Cohen is a consultant with Bayer. -
A recent study in JAMA Neurology found an association between contaminated water at a military base in the 1970s-80s and the risk of Parkinson’s disease in military service members. What do we know about Parkinson’s and environmental toxins? Series 4, Episode 9
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Guest: Dr. Ray Dorsey, University of Rochester Interviewer: Dr. Sara Stern-Nezer, UC Irvine Disclosures: This episode does not award CME credit. -
There are trillions of bacteria living inside each of our gastrointestinal tracts and there’s growing evidence that those bacteria communicate with the brain. Some researchers are even hopeful that drugs targeted at the gut microbiome could help treat diseases as diverse as Parkinson’s disease, multiple sclerosis, or autism. The nature of this so-called “gut-brain axis” -- the extent to which bacteria might actually shape brain function and disease -- is the topic of our show today. Dr. Sarkis Mazmanian is the Luis and Nelly Sooks Professor of Microbiology in the Division of Biology and Biological Engineering at Caltech. He’s the recipient of many awards, including a MacArthur Genius Grant, for his work on the gut microbiome axis. Series 4, Episode 8
Featuring:
Guest: Dr. Sarkis Mazmanian, Caltech Interviewer: Dr. Adeline Goss, Highland Hospital Producer: Dr. Sara Stern-Nezer, UCI Health Disclosures: Dr. Mazmanian disclosed the following relationships related to this podcast topic: Axial Therapeutics: Board member and Consultant, Nuanced Health: Board member and Consultant, and Seed Health: Board member. This episode does not award CME credit. -
Recently on the podcast we’ve been talking about neurotechnology -- devices that interface with the brain to treat disease, for example by restoring speech function in people with locked-in syndrome, or motor function in people with paralyzed limbs. But listen to the media, and you’ll also hear buzz about neurotechnology for healthy people... Series 4, Episode 7
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Guest: Philip Sabes, PhD, UCSF Interviewer: Rohini Samudralwar, MD, UPENN Disclosures: This episode is non-CME. -
Among several highlights of the recent International Stroke Conference was new evidence supporting endovascular thrombectomy for patients with so-called “large core” ischemic strokes. In current practice, thrombectomy is considered for patients with occlusions of the internal carotid or middle cerebral artery who are less than 24 hours since the last known well and have a small “core” of ischemia on non-contrast head CT or CT or MR perfusion imaging -- in other words, there’s radiographic evidence that only a small core of the brain has suffered permanent injury and a larger penumbra of tissue can be saved. SELECT-2 is a multicenter randomized controlled trial that examined whether patients with LARGE cores of ischemic tissue could ALSO benefit from thrombectomy. On our show today we have SELECT-2 principal investigator Dr. AM-rou sou-RAJ, who is also Professor of Neurology at Case Western Reserve University School of Medicine. He was interviewed by Dr. Michelle Johansen, vascular neurologist at Johns Hopkins University, about what the study results might mean for stroke care -- and stroke imaging -- going forward. Series 4, Episode 6. Featuring:
Guest: Amrou Sarraj, MD FAHA, Professor of Neurology, Case Western Reserve University School of Medicine, George M. Humphrey II Endowed Chair, University Hospitals Neurological Institute, Director, Comprehensive Stroke Center and Stroke Systems, University Hospitals Interviewer: Dr. Michelle Johansen, Johns Hopkins Medicine Producer: Dr. Joseph Carrera, University of MichiganDisclosures: Dr. Sarraj discloses the following relationships: SELECT2 principal investigator - funded by Stryker Neurovascular with research grant to University Hospitals Cleveland Medical Center and UT McGovern Medical School SELECT principal investigator - funded by Stryker Neurovascular with research grant to UT McGovern Medical School Member, Speaker bureau and advisory board - Stryker Neurovascular Provided advisory services to AstraZeneca, Genentech and Lumosa Theraputics
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Concussion, or mild acute traumatic brain injury, is incredibly common -- 1 in 5 of adolescents report having suffered a concussion at some point in their lifetime (JAMA. 2021;325(17):1789-1791)... and an estimated 1 in 5 players of contact sports suffer a concussion each season. Sports neurologists are rare enough that most people suffering concussions are never seen by one. And general neurologists aren’t always well-trained to treat this condition, especially as the science of concussion is advancing. Our guest today, Dr. Jose Posas is a sports neurologist and residency program director at Ochsner Medical Center in New Orleans and he spoke to ANA producer Dr. Mandy Jagolino-Cole of The University of Texas Health Science Center at Houston about recent findings in concussion research and how we can apply that research at the bedside. Series 4, Episode 5. Featuring:
Guest: Dr. Jose Posada, Ochsner Medical Center Interviewer/Producer: Dr. Amanda Jagolino Cole, The University of Texas Health Science Center at Houston Disclosures: nonePublication mentioned in the episode: McAllister TW, Broglio SP, Katz BP, Perkins SM, LaPradd M, Zhou W, McCrea MA; Concussion Assessment, Research and Education (CARE) Consortium. Characteristics and Outcomes of Athletes With Slow Recovery From Sport-Related Concussion: A CARE Consortium Study. Neurology. 2023 Jan 18:10.1212/WNL.0000000000206853. doi: 10.1212/WNL.0000000000206853. Epub ahead of print. PMID: 36653178. https://pubmed.ncbi.nlm.nih.gov/36653178/
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On our December show, we talked about ethical issues surrounding brain-computer interfaces. We’ll pick up the topic again this month with a discussion about one type of brain-computer interface: neuroprosthetics. Our guest is Dr. Edward Chang, Professor and Chair of Neurological Surgery at the University of California San Francisco. Dr. Chang is an expert in brain mapping during neurosurgery, with the aim of preserving the brain areas responsible for language, speech, movement and emotion. His research focuses on neuro-prosthetics that can restore movement in people who are paralyzed and speech in people with speech disorders. As we’ll talk about today, this research raises interesting ideas about the neural representation of speech and language and the ethics surrounding brain-computer interfaces. Dr. Chang was interviewed by ANA Producer Dr. Amanda Jagolino-Cole of The University of Texas Health Science Center at Houston. Series 4, Episode 4. Featuring:
Guest: Edward Chang, MD, Professor, Neurological Surgery, UCSF Weill Institute for Neurosciences, School of Medicine Interviewer/Producer: Amanda L Jagolino-Cole, MD, FAHA, FAAN, Associate Professor of Neurology, Director of UT Teleneurology, Vascular Neurology Fellowship Program Director, UTHealth | The University of Texas Health Science Center at Houston, McGovern Medical School Disclosures: Dr. Chang and UCSF have intellectual property related to algorithms for BCI, Dr. Chang is a consultant for Synchron -
Football audiences were shaken on January 2nd when Buffalo Bills safety Damar Hamlin suffered a cardiac arrest after a tackle during a Monday Night Football game. He was resuscitated on the field and then transferred to the University of Cincinnati Medical Center in critical condition. Thus began a waiting period, all too familiar to neurologists, while the world wondered to what extent Mr. Hamlin’s brain would recover. But remarkably, just 4 days later, Mr. Hamlin was able to communicate in writing. He was extubated the following day and discharged home on January 11th. Our guest on today’s podcast, ANA Vice President and Johns Hopkins University neurointensivist Dr. Romer Geocadin, says that Mr. Hamlin’s story should inspire hope... not only for families of survivors of cardiac arrest but also for researchers and physicians. Romer was interviewed by ANA Education Innovation committee Chair and UCSF Neurohospitalist Dr. Megan Richie for this special episode of ANA Investigates.... on cardiac arrest and paths to recovery. Series 4, Episode 3. Featuring:
Guest: Dr. Romer Geocadin, ANA Vice President and Johns Hopkins University neurointensivist Interviewer/Producer: Dr. Megan Richie, ANA Education Innovation committee Chair and UCSF Neurohospitalist -
The emergence of the syndrome known as long COVID has brought new attention to myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS). In this episode, we explore the advances in science that may soon lead to answers. Series 4, Episode 2. Featuring:
Guests: Drs. Sonya Marshall-Gradisnik & Kiran Thapaliya from the National Centre for Neuroimmunology and Emerging Diseases (NCNED), Griffith University, Queensland, Australia Interviewer/Producer: Dr. Megan Richie, UCSF - Visa fler
