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RUSK Insights on Rehabilitation Medicine

RUSK Insights on Rehabilitation Medicine is a top podcast featuring interviews with faculty and staff of RUSK Rehabilitation as well as leaders from other rehabilitation programs around the country. These podcasts are being offered by RUSK, one of the top rehabilitation centers in the world. Your host for these interviews is Dr. Tom Elwood. He will take you behind the scenes to look at what is transpiring in the exciting world of rehabilitation research and clinical services through the eyes of those involved in making dynamic breakthroughs in health care.
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Now displaying: July, 2022
Jul 20, 2022

Dr. Koto Ishida is an Associate Professor in the Department of Neurology at NYU Grossman School of Medicine. She also serves as Medical Director of the Stroke Program at NYU Langone Health and Director of Clinical Affairs at the Center for Stroke and Neurovascular Diseases. She is Board-certified both in vascular neurology and neurology by the American Board of Psychiatry & Neurology. Her medical degree is from the University of Rochester. She completed her residency in neurology at the Hospital of the University of Pennsylvania where she had a fellowship in vascular neurology. Dr. Ishida has her name on 70 publications in the professional literature.    

This is a special three-part series.

The following topics were discussed in Part 1:  how common strokes are; distinguishing features of ischemic and hemorrhagic stroke; some major causes of a stroke and if genetics and family history are among them; from the standpoint of sex and gender, if there are any differences in specific risk factors, differences in presentation, response to treatment, and stroke outcomes between what commonly are referred to as male and female; how the acronym FAST is applicable and the importance of going to a hospital as soon as possible upon experiencing stroke symptoms; and the likelihood that a patient may have a non-cerebrovascular disease that mimics a stroke, and if so, how to distinguish between stroke and non-stroke symptoms.
Jul 6, 2022

Douglas H. Smith, MD, is the Robert A. Groff Endowed Professor Neurosurgery and Director of the Center for Brain Injury and Repair at the University of Pennsylvania. He is the Scientific Director of the Big 10/Ivy League Collaboration on Concussion and also serves as a member on the Scientific Advisory Boards of the US National Football League (NFL), the National Collegiate Athletic Association (NCAA)-DoD consortium on concussion, and the International Concussion Society. 

This is the second part of a two-part series. In this one, he points out that:

We find that when we are looking at over time the changes of profiles, it means they are appearing and disappearing. How does that look like compared to the appearance of those proteins in the blood?  We are finding an interesting correlation that is kind of a combination between how open the blood brain barrier is and how much axon pathology is. It has become possible to diagnose the 20 percent of patients who will have persistent symptoms at the time they come to the ED and then we can direct them to you in rehabilitation. The next step is to have a clinical trial. He asked how all this links with neurodegeneration? Within hours of an injury, it can begin to look like an Alzheimer’s disease brain. Something is going on that is crazy. An axon injury is one that can keep on taking. Tau is what gets all the big news. It may be too simplistic a view. It is not just tau. It actually is a whole bunch of things happening to the brain. Many other different types of neuropathologies occur in the brain that are initiated by injury. A subset of patients will develop these changes. If males dominate concussions, which they do, in theory you would think that they possibly would dominate dementia or mild cognitive impairment later in life, but that is not true. Women have a higher rate. There is a lot of work to be done. A lot of people who have concussions are going to be fine and we need to find a way to avoid having people worry and cause stress. A Question and Answer period followed  the presentation.

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