Shadowing Practice: Intracranial Atherosclerotic Disease (ICAD) | Cedars-Sinai - Learn English Speaking with Video
Creating lesson...
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I am Dr. Michael Alexander.
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I'm a neurosurgeon and vice chair of neurosurgery at Cedars -Sinai Medical Center.
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ICAD is a term we use to describe cholesterol blockages in the brain arteries.
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So ICAD is an acronym for intracranial atherosclerotic disease, and that can cause strokes.
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Most of the people with ICAD have certain risk factors so they're smokers, they may have high cholesterol,
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diabetes, obesity, and sometimes a family history of cholesterol blockages in the arteries.
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So ICAD can affect any race or ethnicity.
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It has a higher incidence in Asians, Latinos, and African Americans.
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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.
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As the blockage gets tighter and tighter, there's less blood flow getting to the brain.
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So patients may experience TIAs, which is a temporary type of stroke, where they may have temporary trouble with speaking,
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temporary numbness or weakness in their arms or legs, or problems with balance or dizziness.
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And those can be the early warning signs of ICAD.
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Later on in the disease, patients may have a stroke which may have those similar symptoms where they have permanent problems,
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speaking, permanent weakness, etc. And those are the symptoms we want to prevent with some of the treatments that we have.
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Cedars -Sinai has been assessing and treating patients with ICAD for many years.
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We were one of the first centers to have high resolution MRA imaging of the brain
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and what What that does is it specifically looks at the brain arteries with contrast using dye
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to see if there's any inflammation of the cholesterol plaque and see if patients are at high risk for having further strokes.
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We are also one of the first centers to run major national trials looking at stenting for ICAD.
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So trying to open up the blocked arteries in the brain with stents
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and using these techniques to prevent more strokes in the future.
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So Cedars -Sinai, we ran the first two FDA approved trials in the last decade called the WEAVE trial
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and the WOVEN trial to look at stenting in patients who have high degree blockages in their brain arteries.
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So when a patient's referred to us, we have a team approach to treating them or assessing them.
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So the stroke neurologist will do basic tests on their blood
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and perhaps some other imaging of the brain besides MRI such as CT perfusion
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which is a CAT scan where we look at the blood flow to the brain to see
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if there's actually compromised blood flow in the area of the blocked artery.
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The neurosurgeons, neurointerventionalists, and neuroradiologists all help participate in both the assessment
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and treatment of the patient so it's a true team approach.
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For most patients, this treatment prevents or reduces the number of strokes patients will have in the future.
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For some patients, that actually improves their neurologic condition.
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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.
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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.
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I think some of the questions that patients and their families have about ICAD is, number one, are they a candidate for treatment?
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Because many patients are told that they aren't a candidate for any other treatment other than medical therapy, and that's not true.
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So they want to know, are they a candidate?
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Secondly, patients want to know what the risks are with this type of treatment.
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There's risks with any type of treatment, even just medical therapy alone.
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But what we found from the WEAVE trial is
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that the risk of doing the stent treatment is actually very low now compared to where it was 10 years ago.
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And so it is in a very good safety range for treatment as long as the patient meets the criteria.
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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,
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what the symptoms are, and what the treatment options are.
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Vocabulary and speaking notes for this lesson
This C1 speaking lesson is built on the video “Intracranial Atherosclerotic Disease”. The speaker keeps coming back to these words: patient, treatment, Icad, brain, stroke. This video has 45 sentences and 714 words to shadow. The speech runs for 4:38. The speaker talks at a natural 154 words per minute, close to everyday conversation. Only 80% of the words are among the 3,000 most common in English, so the vocabulary is demanding.
Key vocabulary in this video
The 15 most advanced words in the video, with pronunciation and meaning:
| Word | Pronunciation | Meaning |
|---|---|---|
| artery noun | /ˈɑɹ.təɹ.i/ | Any of the muscular- and elastic-walled blood vessels forming part of the circulation system by which blood is conveyed away from the heart regardless of its… |
| blockage noun | /ˈblɑkɪd͡ʒ/ | The state or condition of being blocked. |
| symptom noun | /ˈsɪm(p)təm/ | A perceived change in some function, sensation or appearance of a person that indicates a disease or disorder, such as fever, headache or rash; strictly, a… |
| cholesterol noun | /kəˈlɛstəɹɒl/ | A sterol lipid synthesized by the liver and transported in the bloodstream to the membranes of all animal cells; it plays a central role in many biochemical… |
| stent noun | /stɛnt/ | A slender tube inserted into a blood vessel, a ureter or the oesophagus in order to provide support and to prevent disease-induced closure. |
| dizziness noun | The state of being dizzy; the sensation of instability. | |
| neurosurgeon noun | A surgeon specializing in brain surgery. | |
| assess verb | /əˈsɛs/ | To determine, estimate or judge the value of; to evaluate; to estimate. |
| acronym noun | /ˈækɹənɪm/ | Generally such abbreviations, including those pronounced as individual letters (initialisms such as "TNT"). |
| atherosclerotic adjective | Of, pertaining to, or afflicted with atherosclerosis. | |
| cerebellum noun | /ˌsɛrəˈbɛləm/ | Part of the hindbrain in vertebrates. In humans it lies between the brainstem and the back of the cerebrum and is formed of two lateral lobes and a median… |
| criterion noun | /kɹaɪˈtɪɹ.i.ən/ | A standard, test, or requirement by which individual things or people may be compared and judged; a gauge. |
| diagnose verb | /ˈdaɪ.əɡˌnoʊs/ | To determine which disease is causing a sick person's signs and symptoms; to find the diagnosis. |
| intracranial adjective | /ˌɪntɹəˈkɹeɪniəl/ | Of or pertaining to the brain or inside of the head; within the cranium. |
| neurointerventionalist noun | A neurological interventionalist |
Phrasal verbs you will hear
| Word | Meaning |
|---|---|
| open up verb | To open. |
Pronunciation to watch
The speaker uses 3 contractions and reduced forms, such as aren't, I'm, they're. Say them the short way, as you hear them.
- The “sh” and “zh” sounds: perfusion /pəɹˈfjuʒən/, inflammation /ɪnfləˈmeɪ̯ʃən/
- Long words — get the stress right: cholesterol /kəˈlɛstəɹɒl/, cerebellum /ˌsɛrəˈbɛləm/, criterion /kɹaɪˈtɪɹ.i.ən/, intracranial /ˌɪntɹəˈkɹeɪniəl/, neurological /nɝəˈlɑd͡ʒɪkəl/
How to practise with this video
- Listen to the whole video once without speaking and note the words you do not know.
- Start at 0.75× speed, shadow it sentence by sentence, then go back to normal speed once it feels easy.
- Record yourself and compare with the original, paying attention to words like artery, blockage, symptom.
What is the Shadowing Technique?
Shadowing is a science-backed language learning technique originally developed for professional interpreter training and popularized by polyglot Dr. Alexander Arguelles. The method is simple but powerful: you listen to native English audio and immediately repeat it out loud — like a shadow following the speaker with just a 1–2 second delay. Unlike passive listening or grammar drills, shadowing forces your brain and mouth muscles to simultaneously process and reproduce real speech patterns. Research shows it significantly improves pronunciation accuracy, intonation, rhythm, connected speech, listening comprehension, and speaking fluency — making it one of the most effective methods for IELTS Speaking preparation and real-world English communication.