Stroke


    More than 2,400 years ago the father of medicine, Hippocrates, recognized and
    described stroke-the sudden onset of paralysis. Until recently, modern medicine
    has had very little power over this disease, but the world of stroke medicine is
    changing and new and better therapies are being developed every day. Today, some
    people who have a stroke can walk away from the attack with no or few
    disabilities if they are treated promptly. Doctors can finally offer
    stroke patients and their families the one thing that until now has been so hard
    to give: hope.

    In ancient times stroke was called apoplexy,* a general
    term that physicians applied to anyone suddenly struck down with paralysis.
    Because many conditions can lead to sudden paralysis, the term apoplexy did not
    indicate a specific diagnosis or cause. Physicians knew very little about the
    cause of stroke and the only established therapy was to feed and care for the
    patient until the attack ran its course.

    The first person to investigate the pathological signs of apoplexy was Johann
    Jacob Wepfer. Born in Schaffhausen, Switzerland, in 1620, Wepfer studied
    medicine and was the first to identify postmortem signs of bleeding in the
    brains of patients who died of apoplexy. From autopsy studies he gained
    knowledge of the carotid and vertebral arteries that supply the
    brain with blood. He also was the first person to suggest that apoplexy, in
    addition to being caused by bleeding in the brain, could be caused by a blockage
    of one of the main arteries supplying blood to the brain; thus stroke became
    known as a cerebrovascular disease (“cerebro” refers to a part of the
    brain; “vascular” refers to the blood vessels and arteries).

    Medical science would eventually confirm Wepfer’s hypotheses, but until very
    recently doctors could offer little in the area of therapy. Over the last two
    decades basic and clinical investigators, many of them sponsored and funded in
    part by the National Institute of Neurological Disorders and Stroke (NINDS),
    have learned a great deal about stroke. They have identified major risk factors
    for the disease and have developed surgical techniques and drug treatments for
    the prevention of stroke. But perhaps the most exciting new development in the
    field of stroke research is the recent approval of a drug treatment that can
    reverse the course of stroke if given during the first few hours after the onset
    of symptoms.

    Studies with animals have shown that brain injury occurs within minutes of a
    stroke and can become irreversible within as little as an hour. In humans, brain
    damage begins from the moment the stroke starts and often continues for days
    afterward. Scientists now know that there is a very short window of opportunity
    for treatment of the most common form of stroke. Because of these and other
    advances in the field of cerebrovascular disease stroke patients now have a
    chance for survival and recovery.

    *Terms in Italics are
    defined in the glossary.

     

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