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Episode 977: Amyloid Therapy and Stroke-like Events
In this episode, we explore the implications of new antiamyloid therapies for Alzheimer's patients, particularly regarding their potential to cause stroke-like symptoms. The discussion highlights...
Episode 977: Amyloid Therapy and Stroke-like Events
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Speaker A
This is the Emergency Medical minute sponsored by CarePoint, NHCA Health One.
Speaker B
All right, welcome. Morning, everybody. So at first, the topic of new therapies for Alzheimer's might not sound that relevant for us, but there's a part of this that will be relevant. So we see a lot of patients with Alzheimer's and there's a lot of different medications patients could be on. And there's a new category of Alzheimer's medications called antiamyloid therapies. And the idea is that people who have Alzheimer's get these things called amyloid plaques that build up in parts of their brain. And then these new treatments, which are the anti amyloids, try and break down these amyloid plaques and try and kind of reverse some of the symptoms of Alzheimer's. And there's some hope that maybe they'll be helpful. But the issue is that they can also cause deposition of these amyloid in other parts of the brain and they can cause new neurologic symptoms. Sometimes it can be headaches, vertigo, but it can also cause acute stroke like symptoms that can masquerade as a stroke. And one of the issues is you can't see these new amyloid deposits on CT. You can only be seen on MRIs. And, and there's a term for them called ARIA, amyloid related imaging abnormalities. So the point is that when patients with Alzheimer's come in with acute neurologic symptoms, it could either be a real stroke or it could be something related to their medications. And it might not be able to differentiate based on ct. And the other kind of problem is that because of these amyloid deposits, if these patients get treated with three thrombolytics, if you think it's an acute stroke and you don't see anything like a bleed on ct, they are more likely to have hemorrhages or bleed from the thrombolytics because of the way the amyloid affects the brain. So the main point is that if we see somebody who has what we think is a stroke and they have a history of Alzheimer's, we and the neurologists really need to figure out if they're on these new medications. As medications become more common, because the workup might require an mri, we know that's a bit of a challenge. And the treatment which we would typically do might be dangerous. You know, sometimes these patients might not get the treatment until they get the mri. Even if they have a real stroke, they might need endovascular IR treatment, not necessarily medication with thrombolytics. So kind of interesting thing to keep in mind that, you know, we'll need to be more aware of with Alzheimer's patients who have stroke symptoms. Thanks, everybody.
Speaker A
This has been the Emergency Medical Minute. Thank you to our sponsors, CarePoint and HCA Health One. Support from them and listeners like you helps us to continue providing free medical education to the masses. If you found this episode valuable, consider supporting our work and check out the link in our show notes.
Topics Covered
Alzheimer's therapies
antiamyloid therapies
amyloid plaques
neurologic symptoms
acute stroke symptoms
ARIA
amyloid related imaging abnormalities
thrombolytics
MRI in stroke diagnosis
Alzheimer's medication risks
emergency medical education
CarePoint sponsorship
HCA Health One
patient treatment challenges
neurologist collaboration