Steven D Chang MD
Steven D Chang MD
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Video

Surgical Approaches to Trigeminal Neuralgia: A Summary - Dr. Amid Persad
zhlédnutí 78Před měsícem
Surgical Approaches to Trigeminal Neuralgia: A Summary - Dr. Amid Persad
Treatment of Meningiomas - A Panel Discussion with Dr. David Park and Dr. Amid Persad
zhlédnutí 364Před měsícem
A Panel Discussion with Dr. David Park and Dr. Amid Persad
Complimentary Film Review by Dr. Chang
zhlédnutí 85Před 4 měsíci
For review of MRI films for patients with brain tumors
Acoustic Neuroma Case Presentations and Panel Discussion
zhlédnutí 141Před 5 měsíci
Acoustic Neuroma Case Presentations and Panel Discussion
A Step by Step Evaluation and Treatment of Trigeminal Neuralgia
zhlédnutí 230Před 7 měsíci
A Step by Step Evaluation and Treatment of Trigeminal Neuralgia
Meningioma : How to Minimize Risk and Maximize Your Surgery Outcomes
zhlédnutí 1,2KPřed 7 měsíci
Meningioma : How to Minimize Risk and Maximize Your Surgery Outcomes
Should I be worried about having multiple MRI scans for my AVM?
zhlédnutí 85Před 8 měsíci
Should I be worried about having multiple MRI scans for my AVM?
Are AVMs hereditary?
zhlédnutí 17Před 8 měsíci
Are AVMs hereditary?
AVM - Watch and wait with periodic MRI scans, what are the risks?
zhlédnutí 37Před 8 měsíci
AVM - Watch and wait with periodic MRI scans, what are the risks?
How often to get MRI scans after AVM surgery or radiation?
zhlédnutí 52Před 8 měsíci
How often to get MRI scans after AVM surgery or radiation?
When should an AVM not be treated?
zhlédnutí 18Před 8 měsíci
When should an AVM not be treated?
Embolization for AVMs
zhlédnutí 46Před 8 měsíci
Embolization for AVMs
Risks of Radiosurgery for AVMs
zhlédnutí 63Před 8 měsíci
Risks of Radiosurgery for AVMs
When is radiation an option for AVMs?
zhlédnutí 36Před 8 měsíci
When is radiation an option for AVMs?
Risk Factors with AVM Surgery
zhlédnutí 48Před 8 měsíci
Risk Factors with AVM Surgery
When is surgery indicated for AVMs?
zhlédnutí 31Před 8 měsíci
When is surgery indicated for AVMs?
What are 3 different treatment options for AVMs?
zhlédnutí 35Před 8 měsíci
What are 3 different treatment options for AVMs?
How do AVMs develop?
zhlédnutí 10Před 8 měsíci
How do AVMs develop?
What symptoms can I expect from an AVM?
zhlédnutí 37Před 8 měsíci
What symptoms can I expect from an AVM?
AVMs - Why are MRI scans and Angiograms the gold standard for the diagnosis of AVM?
zhlédnutí 28Před 8 měsíci
AVMs - Why are MRI scans and Angiograms the gold standard for the diagnosis of AVM?
How long have we known about AVMs?
zhlédnutí 17Před 8 měsíci
How long have we known about AVMs?
Can you tell us what is an AVM?
zhlédnutí 24Před 8 měsíci
Can you tell us what is an AVM?
Should I be worried about having multiple MRI scans for my acoustic neuroma?
zhlédnutí 101Před 9 měsíci
Should I be worried about having multiple MRI scans for my acoustic neuroma?
Are acoustic neuromas hereditary?
zhlédnutí 32Před 9 měsíci
Are acoustic neuromas hereditary?
Radiosurgery for acoustic neuroma - when will it stop growing?
zhlédnutí 88Před 9 měsíci
Radiosurgery for acoustic neuroma - when will it stop growing?
Periodic MRI scans for acoustic neuroma - watch and wait, what are the risks?
zhlédnutí 117Před 9 měsíci
Periodic MRI scans for acoustic neuroma - watch and wait, what are the risks?
Risks Factor When Treating an Acoustic Neuroma
zhlédnutí 43Před 9 měsíci
Risks Factor When Treating an Acoustic Neuroma
How long have we known about acoustic neuromas?
zhlédnutí 29Před 9 měsíci
How long have we known about acoustic neuromas?
What is an acoustic neuroma? What types of people develop these types of tumor?
zhlédnutí 49Před 9 měsíci
What is an acoustic neuroma? What types of people develop these types of tumor?

Komentáře

  • @JeffHogue-em6zx
    @JeffHogue-em6zx Před 23 hodinami

    Can supplements like alpha lipoic acid and turmeric/curcumin restore the sheath on the nerve ?

  • @JeffHogue-em6zx
    @JeffHogue-em6zx Před 23 hodinami

    Can the pain be caused by sinus infections or problems in the sinus cavity ? 2024 is my 50th anniversary "living" with TN. One thing I have noticed over the years is that mid-summer, especially around July, my pain symptoms would return, after not having pain for months. When the pain would return, it would be present for many weeks to months. Thank you. (my pain is on the left side, at V3 and isn't always electrical. It is sometimes burning, sometimes like a strong pinching of my tongue, and a dull tolerable pain, to no pan)

  • @m.rommiemclane14
    @m.rommiemclane14 Před 4 dny

    Recently diagnosed with falcine meningioma with parathesia and burning sensation bilaterally feet to posterior legs to hands to face. Is this location difficult to remove surgically?

  • @mannylss
    @mannylss Před 6 dny

    I loved this! As someone that want to be a neuro surgeon i love watching these, the explainations were perfect!

  • @Sarah-je7op
    @Sarah-je7op Před 15 dny

    Recently, after having an MRI done, doctors found a benign tumor of cerebral meninges/meningioma. I'm not sure if I should have the tumor removed. I would be grateful to receive your expert opinion.

  • @lorrainecamilleri1615
    @lorrainecamilleri1615 Před 21 dnem

    Can radiation on residual meningioma tumor cause bells palsy or hearing loss ?

  • @lorrainecamilleri1615
    @lorrainecamilleri1615 Před 21 dnem

    Can radiation on residual meningioma tumor which was pressing on trigeminal nerve cause bells palsy or hearing loss ?

  • @SBattheBEACH23
    @SBattheBEACH23 Před 27 dny

    Hello, I am a 60 year old woman diagnosed with a Meningioma 2 years ago. The Neurologist told me about the Meningioma but he did not/would not show me my scans. It appears to be slow growing. The first Meningioma was measured 1.0 x .07. One year later the Meningioma measured 1.0 x .08. From the first day that I found out about the tumor I wanted it removed. The Neurologist said no. I have been sick for the past 2 years, the Neurologist says NONE of my symptoms are the result of the tumor. I have terrible headaches/migraines, I have tried 5 different medications, each medication made me feel worse than just having the headaches. I previously did not have many headaches, now I have to be in a dark room with an ice pack on my head praying for sleep so I don’t feel the headache. Not being sure where in my brain the Meningioma is located I feel lost about my own health. In addition to the headaches I currently have speech difficulties, gait disturbances, loss of coordination and falling often. i have osteoarthritis, fibromyalgia, high cholesterol, high blood pressure, degenerative disc disease with extreme back pain, SICCA, GERD, and the most debilitating symptom for me is the fatigue. No matter how long I sleep I never feel rested. I stopped working 2 years ago, I was unable to fulfill my duties. I have been on LTD while I wait for SSDI to make a decision regarding my claim. I am now experiencing memory loss, cognitive issues, muscle weakness, and I struggle with concentration, screen time and reading books. I live in Myrtle Beach, South Carolina and this area is not known for stellar health care providers. Is there any way for me to send you my 2 MRI results and get your opinion? I am desperate for information about my own Meningioma. Thank you in advance!!!

    • @stevendchangmd6447
      @stevendchangmd6447 Před 17 dny

      I will happy to look at your MRI, please send email to veevo@stanford.edu , Vee will give you instructions on how to send your films to us

  • @christinebrunton1489
    @christinebrunton1489 Před měsícem

    Thanks for the Information 🙂. I need Help with this I live in Ontario Canada & I've had Head& Face Pain for years!! Trigeminal Neuralgia happened to me after a Meningioencelocele& CSF Leak Surgery. I was losing Brain Fluid out my Right Sphenoid Sinus!!; Sick ever Since!

  • @andrewchoi9908
    @andrewchoi9908 Před měsícem

    Thank you doctor Park!!

  • @YvonneCharles-wu9rq
    @YvonneCharles-wu9rq Před měsícem

    Hi Dr. Chang, I was listening to your webinar just now, but apparently my question did not go through. I had TN with surgery on 6/2/23, fluid was leaking from surgical site, 2nd surgery in July 2/2023. Got very confused, remain four months in Hospital. To this day I have feelings of hair in my oral cavity, plus other sensation. Poor appetite, decrease in taste. Can you help with what I can use to help this. Thank you. Webinar was very interesting.

  • @YvonneCharles-wu9rq
    @YvonneCharles-wu9rq Před měsícem

    Hi Dr. Chang, I was listening to your webinar just now, but apparently my question did not go through. I had TN with surgery on 6/2/23, fluid was leaking from surgical site, 2nd surgery in July 2/2023. Got very confused, remain four months in Hospital. To this day I have feelings of hair in my oral cavity, plus other sensation. Poor appetite, decrease in taste. Can you help with what I can use to help this. Thank you. Webinar was very interesting.

  • @YvonneCharles-wu9rq
    @YvonneCharles-wu9rq Před měsícem

    Hi Dr. Chang, I was listening to your webinar just now, but apparently my question did not go through. I had TN with surgery on 6/2/23, fluid was leaking from surgical site, 2nd surgery in July 2/2023. Got very confused, remain four months in Hospital. To this day I have feelings of hair in my oral cavity, plus other sensation. Poor appetite, decrease in taste. Can you help with what I can use to help this. Thank you. Webinar was very interesting.

  • @YvonneCharles-wu9rq
    @YvonneCharles-wu9rq Před měsícem

    Hi Dr. Chang, I was listening to your webinar just now, but apparently my question did not go through. I had TN with surgery on 6/2/23, fluid was leaking from surgical site, 2nd surgery in July 2/2023. Got very confused, remain four months in Hospital. To this day I have feelings of hair in my oral cavity, plus other sensation. Poor appetite, decrease in taste. Can you help with what I can use to help this. Thank you. Webinar was very interesting.

  • @YvonneCharles-wu9rq
    @YvonneCharles-wu9rq Před měsícem

    I had surgery on 6/2/23,bld vessel was on the TN. I'm having feelings oh hairs in oral cavity, no appetite, poor appetite. Can you help?

  • @YvonneCharles-wu9rq
    @YvonneCharles-wu9rq Před měsícem

    I had surgery on 6/2/23,bld vessel was on the TN. I'm having feelings oh hairs in oral cavity, no appetite, poor appetite. Can you help?

  • @YvonneCharles-wu9rq
    @YvonneCharles-wu9rq Před měsícem

    How do you treat symptoms from TN that causes a sensation of hairs in oral cavity with no taste and poor appetite. Numbness in teeth and other sensation in tongue and lips

  • @cmauro7912
    @cmauro7912 Před měsícem

    I take it that the Saggital sinus isn't one of them?

  • @lindakelsch6196
    @lindakelsch6196 Před měsícem

    Dr. Chang, Initially numbness to lower mid lip, a spot on R check and pain up into temporal area on R side of head. There has been progression over the past two + years. Bilateral lower jaw dysesthesia/numbness that progressed up lower jaw, into upper jaw, teeth to top of head. Also experiencing oral numbness at tip of tongue, roof of mouth both oral numbness and facial dysesthesia advancing to top of head area and progressing through mouth into throat. Now dysesthesia that never goes away but diminishes when laying down. Dysesthesia advances to peri-orbital eye first inferior then superior. Have pain like jabs to either R or L eye at the side of the eyeball, currently L eye.This journey started after putting too much pressure on the posterior upper cervical neck high immediately developed the lower lip numbness. Does this sound like something that could be what you specialize in? This has been hell for me.....

  • @vasetitoleafoa5583
    @vasetitoleafoa5583 Před měsícem

    Carnivore diet completely cured my trigeminal neuralgia for the first time since 2012

  • @ast-og-losta
    @ast-og-losta Před měsícem

    My 83-year-old father was recently diagnosed. He had symptoms of dementia two months ago, but the doctor sent him home. He started wandering and hallucinating. He received a CT scan that showed a 8cm mass on the front of his brain. The doctor sent him home. My mom found him out in the front yard after falling down the front steps. He finally was admitted to the hospital and has now received an MRI. Why are doctors so slow?

  • @miragonzales6060
    @miragonzales6060 Před 2 měsíci

    .can a 3x3.7x2 tumor is for surgery?

  • @kobenoah1
    @kobenoah1 Před 3 měsíci

    I just found out about my AN. I’ve had depression off and on for a couple years. Always thought it was from just life, getting older, dealing with a difficult spouse, worry for adult children…..Prior to the depression i’ve always been pretty even tempered. At least i know why now. I thought there was something wrong with my brain! Ha! I was right!

  • @kobenoah1
    @kobenoah1 Před 3 měsíci

    I have dumb question. Can diet help or hurt the growth of tumor? Mine is about 16 mm. I also get gut pain (mild) a lot

  • @steviguzman-falukos2423
    @steviguzman-falukos2423 Před 3 měsíci

    What of small meningiomas that cause issues? I just had an MRI because of experiencing ongoing dizziness, headaches, and a seizure. I had 2 concussions in less than 8 months due to dizziness and falling. They found a 1cm tumor. I’ve yet to see a neurologist (my appointment is scheduled for 2 months out). I can barely drive or work due to dizziness. It’s in my frontal lobe. Will I be told to wait and observe?

    • @stevendchangmd6447
      @stevendchangmd6447 Před 3 měsíci

      If there is any suspicion that the menignoma is causing problems, you may want to just have it out. That would be the only way to determine if the tumor is the cause of the problems and gives you a chance to get better. If the tumor is in the frontal lobe, it would be easy to get out

  • @DanheYang
    @DanheYang Před 3 měsíci

    I got high quality education regarding meningioma. He is so caring, knowledgeable and experienced 👍👍👍💝❤❤

  • @DanheYang
    @DanheYang Před 3 měsíci

    Thank you so much ❤❤❤

  • @melinday311
    @melinday311 Před 3 měsíci

    Hello! I've had a menigioma since 2017, and I've had proton beam therapy but my neurosurgeon said I wasn't a candidate for surgery because it's wrapped around my right carotid artery and into my cavernous sinus and I did lose my hearing for 3 weeks and I have right side facial numbness. Should I get a second opinion because he said it's to deep in the brain and I might have strokes or bleed to death on the table if they try to remove it.

    • @stevendchangmd6447
      @stevendchangmd6447 Před 3 měsíci

      It’s hard for me to give you an opinion without looking at your MRI. I am happy to take a look at your MRI scans, please send email to veevo@stanford.edu for a complimentary film review.

  • @DanheYang
    @DanheYang Před 3 měsíci

    Thank you so much ❤❤❤

  • @DanheYang
    @DanheYang Před 3 měsíci

    ❤❤❤Thank you

  • @DanheYang
    @DanheYang Před 3 měsíci

    ❤❤❤

  • @bojigirl5672
    @bojigirl5672 Před 3 měsíci

    I wish I could hear about treatment of difficult meningiomas. Mine is stuck to a big vein on the vermis. He could take only enough for a biopsy. What can be done ever produce a good outcome?

    • @stevendchangmd6447
      @stevendchangmd6447 Před 3 měsíci

      I am happy to take a look at your scans and give you my expert opinion on your meningioma. Please send an email to veevo@stanford.edu to get instructions on how to get setup for a complimentary film review

  • @bojigirl5672
    @bojigirl5672 Před 3 měsíci

    Not all meningiomas are slow growing. Stop saying that blanket statement. Since 2000 the WHO has changed the % of meningiomas of Grade 2 to be 30%

  • @bojigirl5672
    @bojigirl5672 Před 3 měsíci

    Wait, wait, wait a minute! Are you telling me that a woman walks in with a normal neurological exam and headaches and gets an MRI? I begged my oncologist for just a CT to see if there was a mass in my brain after breaking my ankle in a fall, numerous other falls, horrendous headaches that would not respond to medications, dizziness, vertigo, tremendous spontaneous vomiting that would go on for days. Now I have an inoperable timer on my cerebellum because it grew onto a critical vein. Why is there such differences in care. Isn’t med school training supposed to be uniform.

  • @bojigirl5672
    @bojigirl5672 Před 3 měsíci

    My midline cerebellar infratentorual meningioma is attached to a vein that cannot be touched. Surgery yielded only enough material for a biopsy. Grade 1 but not removed. How to treat this one?

  • @bojigirl5672
    @bojigirl5672 Před 3 měsíci

    You have no idea how long it’s been there because you have no data points to tell you how fast it’s growing.

  • @bojigirl5672
    @bojigirl5672 Před 3 měsíci

    You and every other doctor who has not faced life threatening tumors (this is my fourth) are always quick to quote outdated numbers when they minimize the risk. STOP IT. The WHO has done more than the USA. It’s now 60% of meningiomas are GRADE 1. 32% are GRADE 2. I have an inoperable cerebellar tumor that looks like a meningioma but it’s inoperable. No pathology report yet. You personally think about how you would feel when no one can tell you how they would treat this. Oh, meningiomas are 90% easy.

  • @bojigirl5672
    @bojigirl5672 Před 3 měsíci

    It’s not just thinking about putting up headaches at their current pain level. Mine progressed and there is no way to predict how painful they will get. Mine got very bad over 2 years and accelerated in strength.

  • @AsjJohnson127
    @AsjJohnson127 Před 4 měsíci

    ...wow this is really complicated. I was thinking that if it were a younger patient with a pea-sized tumor (in a good location) that may have been there for 15 years without a change but could have very mild symptoms, or maybe it's a 5yo tumor that has no symptoms, then observation would probably make the most sense. But, sounds like, if the tumor were to be new and slowly growing, then there's a certain point that intervention would need to be done, because the tumor would be easier to remove while small, and because the tumor may change grade at some point and begin to grow more rapidly. And if the tumor were to be old and not growing, but have mild symptoms that seem to slightly worsen every several years, then there's the chance of calcium becoming a problem for removal, as well as the tumor just Being There being a problem for the patient. (does that sound right?)

  • @adrianavillagran9008
    @adrianavillagran9008 Před 4 měsíci

    Dr🙏🏻 thanks very much i have meningioma I have a pain like sharp pain in and out and waiting for my MRI and being in touch with you Dr. Chan. Thank you very much for orientation about meningioma ❤

    • @stevendchangmd6447
      @stevendchangmd6447 Před 3 měsíci

      Adriana, I am happy to take a look at your scans and give you my opinion. Please send me an email to veevo@stanford.edu

  • @user-fp8qe7if7u
    @user-fp8qe7if7u Před 4 měsíci

    My "weird" AN symptoms in addition to the normal ear symptoms of my 3.2 cm tumor were: For years, I couldn't feel eye drops when, on occasion, I put them in the eye on the affected side. I couldn't feel the ear swab on the affected side when cleaning my ears. Closer to being diagnosed, I had difficulty getting the affected-side foot into my pants (like the brain signal wasn't getting through to lift the foot). I had a large bump (like an egg) appear on the side of my forehead weeks before surgery for no apparent reason - I did not injure my head at all and it went away fairly quickly. Also, weeks prior to surgery, I leaked CSF one night onto my pillow during sleep - didn't know what it was at the time. I always heard/felt a rush in my head whenever I got up from a sitting position. I had a lazy eye that would show up in photo's - turned out to mild nystagmus due to the tumor. I felt generally unwell for years since my young adult life but plugged along through the years. I was never diagnosed correctly until I forced the pursuit of the problem. I had a root canal I probably didn't need to have - it was likely related nerve pain on the affected side. A few months prior to being diagnosed I had a problem with a lot of overwhelming anxiety which I never had prior in my life. I had concentration issues which I never had before in my fast-paced, technical job. Easy technical stuff became harder for me to focus on and get through. For years, big events like travel or an unrelated illness would take an abnormally long time from which to recover. For years I was always unsteady when using a treadmill - I always drifted to the side and had to hold on a lot. Weeks prior to surgery I felt tremendous pressure within my head - for example if I laughed, it felt like my head would explode. A CSF leak was also repaired during surgery. I also had tachy/ bradycardia breathing issues for years for misdiagnosed reasons (it was tumor/vagus nerve involvement) . I would also lose my voice if I talked for a period of time and water would not help (glossopharyngeal nerve involvement). I fell a few times during my adulthood because I could not recover from a minor stumble - once over a crack in the sidewalk. Also the big thing for me was the constant ear fullness, which I thought would end up being allergy, blood pressure or Meneire's-related. Also closer to diagnosis I started to get numbness under my nose and on my chin. Also normally salted food tasted extremely salty - I would send back food when out to eat because it was too salty in my perception. I also had swallowing problems before surgery and still do. It's been 4 years since surgery and I still have some of these listed symptoms from the tumor/surgery damage along with balance issues. I also lost 75% of tumor-side balance, as officially measured, prior to surgery, so most of my balance was being taken up by the other side of my brain. The doctor probably has seen all this throughout his life-saving career but I am writing all this in case it can help anyone to get to a diagnosis. My strong advice! ... If there is something consistently wrong with your head, demand a brain MRI with contrast, it's really simple to do and can save you years of misdiagnosis and money in unnecessary visits to doctors who have no clue about this. If you ever have this problem, travel to the best surgical teams in the world who do these operations on a regular basis and specialize in them - this point is critical to your outcome. Remember your brain is Houston. (It controls everything in your body). You want/need a highly experienced/educated team handling these types of complicated operations. Also, join the AN group on FB if it still exists - it is exclusive to those going through the problem. Great advice is given and you can ask anything - all your questions get answered fairly well because they have been through it.

  • @MariaSpinler
    @MariaSpinler Před 4 měsíci

    My daughter is suffering from trigeminal neuralgia, she had a root canal that was unfinished. She has been dealing with this for two years. She's had all the symptoms from needle pains to shocking pain ,she can't tolerate wind. She has had the pain so bad ,she couldn't even eat . The medications are not working that well. She doesn't want to have decompression surgery right now, she is fairly young. Would she have any like with the cyber knife treatment.

    • @stevendchangmd6447
      @stevendchangmd6447 Před 4 měsíci

      Hi Maria, if she would like to a consultation or if you would like me to take a look at her films, happy to do so. Please reach out to veevo@stanford.edu, we could get setup with a video visit.

  • @jacobhillanbrand7988
    @jacobhillanbrand7988 Před 4 měsíci

    Can this type of tumor effect breathing?

    • @stratosphericozone2645
      @stratosphericozone2645 Před 4 měsíci

      No.

    • @user-fp8qe7if7u
      @user-fp8qe7if7u Před 4 měsíci

      Absolutely if there is vagal nerve involvement - cranial nerve X - vagus nerve. Look up the function of the vagus nerve.

  • @bojigirl5672
    @bojigirl5672 Před 5 měsíci

    I have an midline infratentorial meningioma that is affecting cerebellum and fourth ventricle. Balance, headaches, vertigo, nausea & vomiting. Surgeon says it’s in a challenging location. I would have liked to hear about the downward facing tentorial meningioma.

  • @Spaceshewarrior
    @Spaceshewarrior Před 5 měsíci

    WOW! I am very grateful for this presentation!

  • @HowardDoss-ij2me
    @HowardDoss-ij2me Před 5 měsíci

    Had MVD 10 years ago. Saved my life.

  • @dianaeifert9299
    @dianaeifert9299 Před 5 měsíci

    68 Female Meningioma Frontal Lobe found 2016 it has grown each year now 1/2” x 1/4” my surgeon said it is kissing my brain. I don’t really want radiation am I making a mistake going straight to surgery

    • @stevendchangmd6447
      @stevendchangmd6447 Před 5 měsíci

      Happy to take a look at your MRI films and give you my opinion. Please send an email to veevo@stanford.edu

  • @melaniecamacho7153
    @melaniecamacho7153 Před 5 měsíci

    Grade 3 i have just had surgery on december 8th now i cant use muse my legs.

    • @El_Roi75
      @El_Roi75 Před 5 měsíci

      Please be patient with yourself ❤. I am just over a year post surgery and I still have moments of complete memory loss. 🙏🏽

  • @lisamadison1184
    @lisamadison1184 Před 6 měsíci

    Can it feel like a foreign object in the area where it hurts so bad. In the upper gum area 41:49

  • @ma.carlaalerta7931
    @ma.carlaalerta7931 Před 6 měsíci

    My mother was diagnose with 0.8cm calcified meningioma should we be worried about this and is operation an option?

    • @stevendchangmd6447
      @stevendchangmd6447 Před 5 měsíci

      I’m happy to look at your mother’s scan and give my recommendation, please email veevo@stanford.edu