Stroke is the third leading cause of death and the leading cause of adult disability in the United States. The UCLA Comprehensive Stroke and Vascular Neurology Program is one of the leading centers in the world for clinical care and research in cerebrovascular disease. The program's mission is to provide comprehensive, state-of-the-art neurologic care for patients with cerebrovascular disease and innovate, through research, new methods to diagnose and treat stroke.

Program distinctions include:

• National Institutes of Health National Institute of Neurologic Disorders and Stroke-Funded SPOTRIAS Acute Stroke Translational Research Center
• Recognized as a national leader by the University Health Consortium
• Site of development of leading worldwide stroke therapies, including clot-busting drugs and the Merci Retriever embolectomy device
• Site of the first dedicated acute stroke unit in California
• First and only JCAHO-certified stroke center in Los Angeles County
• Three core hospitals: Ronald Reagan UCLA Medical Center, UCLA Medical Center, Santa Monica, Olive View-UCLA Medical Center
• Collaborative Stroke Research Network with more than 40 hospitals throughout Los Angeles and surrounding counties

UCLA Stroke and Vascular Neurology Outpatient Clinic:

The UCLA Stroke and Vascular Neurology Outpatient Clinic provides comprehensive evaluation and ambulatory treatment for patients with cerebrovascular disorders, including transient ischemic attacks, carotid artery stenosis, vertebrobasilar artery stenosis, cardioembolic stroke, lacunar stroke cerebral hemorrhage, cerebral vascular malformations, stroke in the young, cerebral artery dissection, moyamoya disease, cerebral vasculitis, hypercoagulable states, and related conditions.

Brain Attack Team and Acute Stroke Unit:

When a stroke occurs, minutes matter. The UCLA Brain Attack Team responds 24 hours per day 365 days a year, providing immediate evaluation and treatment when a patient comes to Ronald Reagan UCLA Medical Center. Patients are admitted to the dedicated, state-of-the-art UCLA Acute Stroke Unit, the first dedicated inpatient unit for stroke care in the state of California. Advanced brain and vessel imaging, continuous physiologic monitoring, and cutting-edge recanalization and neuroprotective therapies are employed to resuscitate threatened brain regions and to optimize stroke prevention regimens.
UCLA Stroke Program Website >

Mobile Stroke Unit:

UCLA Health is the first medical system in the Western U.S. to offer a mobile stroke unit. The Mobile Stroke Unit (MSU) is staffed by a specialty care team comprised of a Stroke Neurologist, Critical Care Transport Nurse, CT Technician, and Paramedic. When an individual calls 911 and says someone is having a stroke, or mentions symptoms that would indicate a potential stroke, our MSU will be dispatched to the scene of the patient alongside another 911 Emergency Response Unit.
UCLA Mobile Stroke Website >

 

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Affiliated faculty

Neurocritical care neurology
Paul M. Vespa, MD (Director)
Manuel Buitrago Blanco, MD, PhD

Health outcomes
Eric Cheng, MD

Neurorehabilitation neurology
Bruce Dobkin, MD (Director)
S. Thomas Carmichael Jr., MD, PhD
David Alexander, MD (Medical Director, California Rehabilitation Institute)
Steve Cramer, MD (Director of Research, California Rehabilitation Institute)
Ahmet Arac, MD
Michael Su, MD (California Rehabilitation Institute)

Basic neuroscience of vascular brain injury
Dennis Fujikawa, MD
Roi Ann Wallis, MD
Claude G. Wasterlain, MD, LScD

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PATIENT INFORMATION

Stroke and Vascular Neurology Clinic appointments provide

• A careful review of the medical history and a thorough neurologic and physical examination
• Review and explanation of key imaging and laboratory studies
• A comprehensive, individualized stroke prevention plan, integrating risk factors, likely stroke mechanisms, and prior treatments
• Review of eligibility for new, innovative stroke research studies

What to bring to the first appointment

• Your insurance card
• Physician referral forms if required by insurance
• A list of current medications, both prescription and over-the-counter, including dose and frequency
• CD-ROMs or X-ray films of any brain MRI scans, brain CT scans, and MR, CT, or catheter angiograms performed (the Stroke Program doctors will want to review the images themselves, not just written reports describing the films)
• Pertinent discharge summaries from recent hospitalizations or outpatient chart notes from recent doctor visits

Insurance and payment information

The UCLA Stroke Center is a provider for Medicare and most major insurance plans. We provide insurance billing. Anything not covered by insurance will be your responsibility. We request payment at the time of your appointment for services that are not covered by insurance. Your insurance company may also require you to pay a co-payment at the time of your appointment. When necessary, our staff will work closely with patients who require a payment plan. If you have any questions regarding which insurance plans we accept or any patient billing concerns, please call us at the phone number below. Questions regarding your coverage and benefits should be directed to your employer or insurance company.

Hospital affiliation

UCLA Health

Patient Privacy

UCLA Health knows that medical information about you is personal and is committed to protecting the privacy of your information. We share your information only to the extent necessary to conduct our business operations, to collect payment for the services we provide you and to comply with the laws that govern health care. We will not use or disclose your information for any other purpose without your permission. We will provide you with a copy of our Notice of Privacy Practices and ask you to acknowledge its receipt.

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CLINICAL TRIALS

Clinical trials evaluate the efficacy and safety of promising new strategies for stroke prevention, stroke diagnosis, and stroke treatment. Tremendous advances in understanding the vascular and neural mechanisms of stroke have occurred over the past two decades and are now beginning to be translated into promising new therapies for stroke patients. Positive findings from clinical trials support the approval of new medications or procedures. The UCLA Stroke and Vascular Neurology Program has designed, led, and/or participated in over 100 clinical trials. If you are interested in potentially participating in a stroke trial, please contact the UCLA Stroke Program at 310-794-6379 or send an email to Stroke Trials

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FELLOWSHIP

The UCLA Vascular Neurology Fellowship was founded in 1996 and expanded to include an ACGME-accredited Vascular Neurology Residency in 2004.

Fellows receive intensive clinical research training in ischemic and hemorrhagic cerebrovascular disease. Core training includes 1) participation a multihospital clinical trial program encompassing novel thrombolytic and mechanical recanalization, cytoprotective, and antithrombotic treatment trials; 2) management of cerebrovascular patients in dedicated stroke unit, neurointensive care unit, emergency department and outpatient settings, 3) performance/interpretation of carotid duplex and transcranial Doppler ultrasound leading to qualification for neurosonology certification. Collaborative research with UCLA's leading interventional neuroradiology and neurovascular surgery services include studies of cerebral angioplasty, catheter administered thrombolysis, vascular malformations, carotid endarterectomy and other conditions. Formal didactic teaching provides additional training in neuroepidemiology, outcomes research, clinical trial design, and biostatistics. Ample additional research opportunities are tailored to fellow interest and, in addition to the above, may include studies of 1) diffusion/perfusion MRI and PET assessment of human cerebral ischemia, 2) oxidative stress in hippocampal slice and whole animal models, 3) neurobehavioral manifestations of cerebrovascular disease, and 4) neuroplasticity and neurorehabilitation. The fellowship is designed to provide comprehensive, state-of-the-art clinical and research training and a fully competitive academic background.

Contact ss: For further information about the UCLA Vascular Neurology Residency/Fellowship, please contact:

David Liebeskind, MD
Director, UCLA Vascular Neurology Residency/Fellowship Program
710 Westwood Plaza
Los Angeles, CA 90095

Phone: 310-794-6379
Fax: 310-267-2063

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STROKE WEB RESOURCES

Additional UCLA stroke-related websites:

• Stroke PROTECT Program
  Physicians, nurses and allied health care providers model educational and clinical materials from UCLA's pioneering in-hospital management program for systematic secondary prevention of atherosclerotic stroke
   
• FAST-MAG Clinical Trial
  UCLA is the clinical coordinating center for this pioneering, NIH-funded clinical trial of neuroprotective therapy for stroke patients begun in the ambulance. Collaborating centers include the Los Angeles Emergency Medical Services Agency and over 40 hospitals in Los Angeles County.
   
• UCLA Stroke Force
  UCLA's unique stroke student research assistant program involves more than 50 UCLA undergraduate students each year in stroke education and stroke clinical trials. Program members travel to local community centers and convalescent homes to lecture on stroke risk, prevention and the critical measures that need to occur after stroke onset. Program members also take shifts in the UCLA Emergency Department, recognizing and evaluating the signs and symptoms of stroke, identifying and screening patients for acute treatment trials, and gathering and analyzing the data under the guidance of Dr. Sidney Starkman and other UCLA Stroke Faculty and Fellows.
   
• Salamon's Neuroanatomy and Neurovasculature Web-Atlas Resource
  An online Neurovasculature Web-Atlas Resource.
   
• UCLA Stroke Center
  Website of the multidepartmental UCLA Stroke Center  

Other stroke web resources

• American Stroke Association
• National Stroke Association
• Stroke Association of Southern California
• National Institutes of Neurological Disorders and Stoke (NINDS)
• The Internet Stroke Center
• Brain Attack Coalition

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ADVANCES FROM UCLA STROKE PROGRAM RESEARCH

The UCLA Stroke and Vascular Neurology Program performs major interdisciplinary clinical and basic research studies of cerebrovascular disease. Stroke Program members collectively have hold over 20 NIH-NINDS cerebrovascular research grants, as well as multiple grants from the American Stroke/Heart Association and the National Stroke Association. The UCLA Stroke Program administers an extensive clinical trial program at over 40 hospitals in West Los Angeles, encompassing at any one time five to 10 Phase II and Phase III trials of neuroprotective, antithrombotic, thrombolytic, and mechanical endovascular treatment strategies.

Selected major research advances from the UCLA Stroke Program

• First validated tool enabling paramedic recognition of stroke
  The Los Angeles Prehospital Stroke Screen (LAPSS). Now part of the curriculum of advanced life support training for paramedics worldwide.
   
• First prehospital neuroprotective treatment of stroke
  UCLA physicians and LA paramedics were the first to give a potentially brainsaving drug to patients in the ambulance, prior to hospital arrival. In the UCLA FAST-MAG Pilot Trial, starting the drug in the ambulance accelerated the start of therapy by 2 hours.
   
• First demonstration of reversal of advanced stroke injury in humans by rapid reopening of blocked arteries
  Using sophisticated brain imaging, UCLA researchers demonstrated that reopening blocked arteries soon after stroke onset can salvage brain regions with advanced bioenergetic failure.
   
• First delineation of the amount of brain circuitry lost in acute stroke
  UCLA researchers demonstrated that the brain loses 2 million nerve cells and 14 billion nerve connections every minute in which treatment does not occur. This finding provided quantitative grounding for the national "Time lost is brain lost" campaign to increase public awareness of stroke symptoms and the importance of calling 911.
   
• First device to remove clots from blocked arteries in acute stroke
  The Merci retriever clot retrieval device is a long thin tube with a corkscrew-shaped tip that is used to grab clots that are blocking arteries and pull them out of the body. This restores blood flow to the threatened brain. The Merci retriever is the first FDA approved device for use in acute stroke and was invented and developed at UCLA.
   
• First device to obliterate brain aneurysms
  The GDC coil allows thin-walled brain aneurysms to be packed and closed through a minimally invasive technique, removing the chance that they will rupture and cause brain hemorrhage, coma, and death. This first device to treat brain aneurysms was invented and developed by the interventional neuroradiology UCLA.
   
• First systematic secondary prevention program for cerebral atherosclerosis
  Plaque buildup in arteries going to the brain is the leading cause of stroke. Seventy-five percent of these strokes can be prevented by known treatments, but these are unfortunately often not given to stroke patients. UCLA developed the Stroke PROTECT program for ensuring delivery of proven therapies to all patients, which became a national model for quality improvement programs nationally.  

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Selected current research programs underway at UCLA (example items)

• Treating patients FAST, in the field
  UCLA is conducting the first large trial of prehospital treatment of stroke ever conducted. In the NIH-funded Field Administration of Stroke Therapy Magnesium (FAST-MAG) Trial, 2,000 paramedics in Los Angeles are starting the neuroprotective drug magnesium sulfate or placebo in the ambulance in 1,298 stroke patients. This is the first trial to treat patients in the "golden hour," the first 60 minutes after stroke onset when virtually all threatened brain tissue is still salvageable.
   
• New clot-busters
  Current clot busting drugs help many patients by opening blocked arteries and restoring blood flow, but sometimes harm patients by causing bleeding into the brain. UCLA is developing a new clot-busting agent, plasmin, which can be fine-tuned to optimize beneficial blood vessel reopening while avoiding bleeding side effects.
   
• Crossing the barrier
  The blood brain barrier normally keeps drugs from crossing from the circulation into the brain. Many promising drugs have failed to work in acute stroke because they could not cross from the blood to the brain fast enough to be active while there was still brain to save. UCLA researchers have designed a "Trojan horse" drug that overcomes this challenge. It consists of a chaperone molecule that crosses the blood brain barrier easily and a neuroprotective molecule highly effective at preserving nerve cells. UCLA will soon be conducting the first in humans testing of this revolutionary strategy for treating acute stroke.
   
• Using a tissue clock, not a time clock
  While some patients with acute ischemic stroke experience rapid death of all threatened nerve cells within one to two hours, others still have salvageable tissue six to 12 hours after onset. UCLA researchers are leading a pathbreaking clinical trial that uses novel magnetic resonance brain imaging to determine precisely how much brain is still salvageable in each patient and select patients for therapy to reopen blocked arteries as late as eight hours after stroke onset.
   
• Plugging holes in hearts
  One quarter of individuals have a patent foramen ovale (PFO), an opening between the right and left upper chambers of the heart that allows blood clots to more easily reach the brain. UCLA researchers are leading a national trial of a novel button device that is deposited in the heart by a catheter to close this opening and reduce the risk of new strokes.

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Contact us

Academic Office

UCLA Stroke Neurology Program
710 Westwood Plaza
Los Angeles, CA 90095
Phone: 310-794-6379
Phone: 310-267-2063

Transfer Center
 Phone: 310-825-0909

Physician Referral Service
Phone: 800-UCLA-MD1 or 800-825-2631  

Donation information
Phone: 310-206-6749

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Director

Faculty

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