May is World Stroke Month and to recognize this health observance, we sat down with American University of the Caribbean alumni and Associate Director of the Stroke Center at Cedars-Sinai Medical Center in Los Angeles, California, Dr. Shlee Song.
Q: Tell us about Cedars-Sinai’s Stroke Center.
There are two comprehensive stroke centers in Los Angeles. At Cedars Sinai, we take care of some of the sickest patients who are exhibiting stroke symptoms—taking on roughly 1,000 stroke admissions per year. We are one of the busiest hospitals in the country.
Beyond the standard of care, we offer clinical trials that have potential for promising stroke treatment. We’re currently offering several National Institutes of Health (NIH) and industry trials for patients.
Q: What are you doing to recognize World Stroke Month?
We are publishing a few articles in the Ceders-Sinai newsletter, Discovery Magazine, including one about a 28-year-old stroke survivor. She collapsed with left-sided weakness and was unable to talk but the ER team transferred her quickly enough to Ceders-Sinai that we did a successful thrombectomy. Now, she’s back to work—walking and talking. The story is a great reminder that young people can get strokes too and taking immediate action upon noticing signs can save lives.
We’re also trying to remind the public about the signs and symptoms of a stroke. Sudden loss of function (e.g., vision, feeling) without pain can signal a stroke and should be taken very seriously. We have a saying, “time is brain” which means it’s important to seek help immediately. Stroke is the leading disabling disease process and the fifth leading cause of death.
Q: How did you get into stroke as a specialty?
I was interested in neurology during my undergrad years at the University of California, Los Angeles (UCLA) and worked with a lot of different development programs and in autism research. When I was at AUC, a classmate suggested I complete my neurology elective at St. Agnus Hospital in Baltimore, MD. I did and it was so rewarding – I had a great teacher and a lot of autonomy with patients.
When I went on to do my residency in neurology at The George Washington University, I noticed dramatic changes in hemiparetic [paralyzed on one side of the body] stroke patients. I saw catheters being used to remove clots and patients were literally walking out of the hospital days later. I wanted to be a part of that, so I pursued a stroke fellowship at the NIH.
Q: What’s up and coming in stroke research and prevention?
There’s a lot in the way of trials and using imaging and diagnostics to advance treatments. The FDA only allows clots to be removed in patients who recently exhibited stroke symptoms but the IWITNESS trial allows us to offer new options for patients whose stroke occurred earlier—patients who may be elderly and live alone. We also participate in MR WITNESS, a phase II trial for stroke subjects who are evaluated within 24 hours from the time they were last known to be well.
Cedars-Sinai has also teamed up with the University of Southern California and UCLA to increase stroke prevention efforts through a medical home model. The leading risk factors for stroke—high blood pressure, diabetes, smoking—can be managed with an advocate checking in on patients to monitor their health and medications. So, we provide patients with a community health worker and after two years, their risk factors are much better managed. Ultimately, the model results in less hospital readmissions.
Q: What would you say to current students thinking about neurology?
Neurology is fascinating—an exam can tell you numerous information about what’s going on in the brain or spinal cord. The field can feel intimidating because it seems so complex but it’s also an area of rapid growth with a lot of resources being directed toward research and treatments. Alzheimer’s disease, ALS, and Parkinson’s disease in particular have received more attention recently.
There are also a lot of opportunities in neurology—it’s a full spectrum specialty. You could go into a more fast-paced acute setting like the neuro-intensive care unit, or you could pursue a more thoughtful, longer approach where you see patients over the course of several years.
