Ep 120 -- How COVID-19 Causes Stroke with Dr. Jason Hinman


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We know that COVID-19 causes stroke in many cases. You can recover from the disease and then still have a stroke caused by the virus. Sometimes the only way you find out you have a COVID-19 infection is that you go to the hospital with a stroke and they tell you. In the US, about 1500 strokes a week are caused by COVID-19.

But why is this happening?

We're starting to get some answer about how COVID-19 causes stroke thanks to the work of Dr. Jason Hinman and his colleagues at the University of California Los Angeles (UCLA). In this episode Jason and I talk about his research and the relationship between Stroke and COVID-19.


Dr. Jason Hinman poses for a professional headshot in his white coat.

Jason Hinman, M.D., Ph.D. - Dr. Hinman is Assistant Professor of Neurology at the David Geffen School of Medicine and Interim Director of the Stroke Program at the West Los Angeles VA Medical Center. Dr. Hinman received his MD/PhD degrees from Boston University School of Medicine.

He completed adult neurology residency training at Ronald Reagan UCLA Medical Center with fellowship training in vascular neurology and stroke rehabilitation also at UCLA. His NIH-funded research laboratory focuses on the molecular pathways at the interface of stroke and Alzheimer's dementia using basic and translational models of stroke and cerebrovascular disease. 

The Model

The technology Jason, Dr. Naoki Kaneko,  and their colleagues use is fascinating. They've taken scans (MRIs, CT scans, Angiograms, etc.) of patients' brains and used those scans to build a physical, 3-D model of the networks of veins and arteries in the brain. This allows them to see just how blood flows and where it struggles.

It also means neurosurgeons who may be planning to fix a patient's aneurysms with a stent or coil could practice on an actual model before going into the patient's brain.

With Jason's research, they line the fake vessels in their model with human epithelial cells. These cells are the same ones that line our real blood vessels. As a result, they were able to observe the way the virus interacts with the blood vessels. Then they learn how that interaction can lead to clots and other blood vessel damage, which, in turn, causes a stroke.

Here's a link to the study: https://www.ahajournals.org/doi/pdf/10.1161/STROKEAHA.120.032764

And here's a link to the press release about the study: https:/newsroom.ucla.edu/releases/covid-19-increased-stroke-risk

The Solution

If you've survived a COVID-19 infection, how can you reduce your chances of having a stroke? Right now, the best research says to eat right, exercise, hydrate, and get good sleep.

In other words, do the things the medical establishment has been telling us to do for years. There's no magic solution. We just have to do the hard work of doing the right thing. Which, of course, is also how you reduce your chances of having a stroke even if you haven't had COVID.

I know. It sucks. But at least it's cheap.


More people are having stroke due to COVID-19. Younger people are having strokes. Many of these strokes can be treated and result in minimal disability if the person gets to the right hospital quickly enough.

So make sure everyone you know can recognize a stroke. Teach them to BEFAST.

Sudden loss or change in Balance, Eyesight, Facial droop, Arm control, Speech or language means that it is Time to call an ambulance.

Stroke symptom graphic

The Important Takeaway

Don't catch COVID-19.

The impacts are long lasting. Even if you survive (and most people will) it still damages your blood vessels, your heart, your kidneys, your lungs, and more. If you survive, the Grim Reaper gets another bite at that apple through COVID inspired stroke and other conditions.

Mask up when you go outside. The mask isn't to protect you. It's to protect anyone else that you see and their families. The fact is there is no way to know for sure if you are infected right now. You could be. I could be. Since symptoms may not show up for a couple weeks, we can't know. Mask up so you don't kill someone or give them a stroke.

Minimize social contact. When you do have that contact, keep your distance. Avoid crowded indoor spaces. If you see someone without a mask, stay away from them. If they get offended, so what? Let them. Afterall they're the ones trying to infect and kill you.

Take advantage of delivery and curbside pickup. Work from home if you can.

Not everyone has those options. Respect people who do have to go out to work by respecting rules intended to reduce transmission.

Many of us don't have to stay locked up 24-7 for months on end. We can go out on occasion, but we have to be responsible about it.

Hack of the Week

It's winter, my Dysport (Botox alternative) is wearing off, and we've had a stressful start to 2021. All that adds up to my tone and spasticity getting stronger and tighter.

When I want to undo that fist I make by default, I could just forcefully  open my fingers, but that just encourages more resistance.

What's for effective is to bend my wrist down (flexion) in the direction the wrist tone want to go anyway. When you bend your wrist down, that naturally encourages your fingers to open up.

The reason for that is that the finger extensors -- the muscles that open your fingers run from your forearm over the top of your wrist and the back of your hand. Bending your wrist down causes them to pull on your fingers, opening your fist.

Give it a try.


Where do we go from here?

Here is the latest episode of The Strokecast

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