Pratique du Shadowing: Intracranial Atherosclerotic Disease (ICAD) | Cedars-Sinai - Apprendre l'anglais à l'oral avec la vidéo

I am Dr. Michael Alexander.

I'm a neurosurgeon and vice chair of neurosurgery at Cedars -Sinai Medical Center.

ICAD is a term we use to describe cholesterol blockages in the brain arteries.

So ICAD is an acronym for intracranial atherosclerotic disease, and that can cause strokes.

Most of the people with ICAD have certain risk factors so they're smokers, they may have high cholesterol,

diabetes, obesity, and sometimes a family history of cholesterol blockages in the arteries.

So ICAD can affect any race or ethnicity.

It has a higher incidence in Asians, Latinos, and African Americans.

Some patients may have no symptoms from ICAD in the early stages, so when there's a small amount of cholesterol blockage, you may have no symptoms at all.

As the blockage gets tighter and tighter, there's less blood flow getting to the brain.

So patients may experience TIAs, which is a temporary type of stroke, where they may have temporary trouble with speaking,

temporary numbness or weakness in their arms or legs, or problems with balance or dizziness.

And those can be the early warning signs of ICAD.

Later on in the disease, patients may have a stroke which may have those similar symptoms where they have permanent problems,

speaking, permanent weakness, etc. And those are the symptoms we want to prevent with some of the treatments that we have.

Cedars -Sinai has been assessing and treating patients with ICAD for many years.

We were one of the first centers to have high resolution MRA imaging of the brain

and what What that does is it specifically looks at the brain arteries with contrast using dye

to see if there's any inflammation of the cholesterol plaque and see if patients are at high risk for having further strokes.

We are also one of the first centers to run major national trials looking at stenting for ICAD.

So trying to open up the blocked arteries in the brain with stents

and using these techniques to prevent more strokes in the future.

So Cedars -Sinai, we ran the first two FDA approved trials in the last decade called the WEAVE trial

and the WOVEN trial to look at stenting in patients who have high degree blockages in their brain arteries.

So when a patient's referred to us, we have a team approach to treating them or assessing them.

So the stroke neurologist will do basic tests on their blood

and perhaps some other imaging of the brain besides MRI such as CT perfusion

which is a CAT scan where we look at the blood flow to the brain to see

if there's actually compromised blood flow in the area of the blocked artery.

The neurosurgeons, neurointerventionalists, and neuroradiologists all help participate in both the assessment

and treatment of the patient so it's a true team approach.

For most patients, this treatment prevents or reduces the number of strokes patients will have in the future.

For some patients, that actually improves their neurologic condition.

So particularly patients who present with dizziness or problems with balance, sometimes they have low blood flow to the back part of the brain called the cerebellum.

And for those patients, as soon as they have increased blood flow, they stop having dizziness and they have better balance just with the treatment.

I think some of the questions that patients and their families have about ICAD is, number one, are they a candidate for treatment?

Because many patients are told that they aren't a candidate for any other treatment other than medical therapy, and that's not true.

So they want to know, are they a candidate?

Secondly, patients want to know what the risks are with this type of treatment.

There's risks with any type of treatment, even just medical therapy alone.

But what we found from the WEAVE trial is

that the risk of doing the stent treatment is actually very low now compared to where it was 10 years ago.

And so it is in a very good safety range for treatment as long as the patient meets the criteria.

For patients to learn more about ICAD, the best resource is going on the Cedars -Sinai website where they can read more about how it's diagnosed,

what the symptoms are, and what the treatment options are.

Qu'est-ce que la technique du Shadowing ?

Le Shadowing est une technique d'apprentissage des langues fondée sur la science, développée à l'origine pour la formation des interprètes professionnels. Le principe est simple mais puissant : vous écoutez de l'anglais natif et le répétez immédiatement à voix haute — comme une ombre suivant le locuteur avec un décalage de 1 à 2 secondes. Les recherches montrent une amélioration significative de la précision de la prononciation, de l'intonation, du rythme, des liaisons, de la compréhension orale et de la fluidité.

Pratique du Shadowing: Intracranial Atherosclerotic Disease (ICAD) | Cedars-Sinai - Apprendre l'anglais à l'oral avec la vidéo

À propos de cette leçon

Qu'est-ce que la technique du Shadowing ?