3 Critical Breakthroughs in Stroke Research

Transcript

• 00:11- The stroke is a very common disease,
• 00:14the brain is not getting enough blood flow
• 00:16because either a blood vessel becomes hardened and narrowed,
• 00:19or it's blocked by a blood clot or it ruptures
• 00:22or it ruptures because the blood vessel wall becomes weak leading
• 00:25to bleeding within the brain or around the brain.
• 00:29- Time is critical in these situations
• 00:31because the longer a blood vessel stays blocked,
• 00:34the more brain cells will die.
• 00:37- There's few things more devastating
• 00:39than a patient having a stroke.
• 00:41It affects their identity, their ability to be productive.
• 00:46Decades ago when you see somebody with a stroke
• 00:49you would provide your empathy
• 00:50and then you'd have to move on
• 00:51because there wasn't much to offer.
• 00:53Doing stroke research, investing in stroke treatments
• 00:56was thought to be a graveyard that's changing.
• 00:59This is reinvigorating stroke research
• 01:02very broadly speaking.
• 01:04- There's an urgency to diagnose
• 01:06through clinical evaluations and neuroimaging
• 01:09and then offer the best treatments
• 01:11that we can for these patients.
• 01:13- Getting those therapies earlier,
• 01:15results in better outcomes.
• 01:18Earlier is important, time matters.
• 01:30When you think about stroke,
• 01:32one of the fundamental things that you need to do
• 01:34is figure out what kind of a stroke patients are having.
• 01:38The only way you can figure that out,
• 01:40is by taking a look with a brain image
• 01:42and MRIs is incredibly safe technology.
• 01:45It's very powerful
• 01:47but because of high magnetic field and power requirements,
• 01:51it's usually in a basement.
• 01:53And as a result, even though it's very important,
• 01:56very difficult for patients to access.
• 01:59Here at Yale, for the first time in the world
• 02:02both developed and deploy a portable MRI machine.
• 02:07We've taken MRI from that secure bunker,
• 02:09and we've brought it to the bedside
• 02:11and this has been incredibly exciting as you can imagine.
• 02:14The pictures are getting better and better,
• 02:17and we're constantly coming up with new ideas
• 02:19for what we can do with a very exciting technology.
• 02:28- Under normal circumstances,
• 02:29the brain has the unique ability to regulate
• 02:32its own blood flow.
• 02:33Brain tissue is very vulnerable during the first hours
• 02:36after stroke.
• 02:37How do we manage blood pressure in the very acute phase
• 02:40after someone has had a stroke?
• 02:42The ideal blood pressure after someone has had a stroke,
• 02:46depends on many factors.
• 02:48So using a one size fits all approach
• 02:50for blood pressure management after stroke,
• 02:52it's likely inadequate.
• 02:53We're currently using neuromonitoring technology
• 02:57that helps us identify the blood pressure that's ideal
• 03:02for this individual person,
• 03:03so that the brain has the best chances
• 03:05to heal from the stroke.
• 03:12- When there's injury anywhere in the body,
• 03:15the body sets up an inflammatory reaction.
• 03:18The same thing happens in the brain.
• 03:20And so we're trying to understand
• 03:21how can we harness the immune systems knowledge
• 03:25about how to repair tissues after they've been injured.
• 03:28Once you've dealt with the initial blood vessel problem
• 03:31either stopped the bleeding,
• 03:33or reopened the blocked blood vessel,
• 03:35we now have a lot of injury that's still ongoing over days.
• 03:39By understanding what the signals are
• 03:42that tell the immune system
• 03:44to stop making pro-inflammatory factors,
• 03:46and start making growth factors,
• 03:48and start healing the brain,
• 03:50we can find new therapies, new treatments
• 03:52for patients with stroke that minimize that early injury
• 03:55and really enhance their ability to recover.
• 03:59- Those patients that come back from a severe stroke,
• 04:02to go on and live a normal, meaningful life,
• 04:05that's really inspiring,
• 04:07even though we're up against a terrible disease,
• 04:10but we're making progress.
• 04:11We're constantly getting better and improving the therapies,
• 04:14and that's because of clinical research.
• 04:22- What motivates me is that the interventions and treatments
• 04:26that we were evaluating and studying 10 years ago,
• 04:29are now part of a standard of care, a clinical practice
• 04:33which is enabling us to reduce death
• 04:35and disability to our patients.
• 04:38- What motivates me in the research realm
• 04:40is thinking that at some point,
• 04:42maybe one of the discoveries that we make in lab,
• 04:44can actually translate into a new therapy
• 04:46that would allow a patient to walk again
• 04:48or speak again, or return to their normal lives.
• 04:51- There's always something nice about trying
• 04:53to attack something that people say can't be done.
• 04:56We're gonna spread towards those areas
• 04:58because they're important,
• 05:00and because we like to do the unique thing.
• 05:02- We want to be able to lead research efforts
• 05:05that change the lives of patients around the world.