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Brain Ischemia pp 337-341 | Cite as

Prefatory Comments

  • Louis R. Caplan

Abstract

The final section of this book considers information gained from clinical stroke research. Until the past few decades, the vast bulk of clinical research in stroke was performed by individual clinician-investigators and small groups. Most studies involved descriptions of findings and phenomenology in various vascular disorders, clinical correlations with pathologic, radiologic or laboratory results, and observations of the course, outcome and treatment of individuals or groups of patients. Recently these so-called ’anecdotal’ studies and reports have appropriately advanced to research that is larger in scope, often involving multiple centers and large numbers of patients or populations in the community, and is quantitative. Stroke clinical research has become a ’numbers game’. During the last two decades the three major central themes have been epidemiological studies, accumulations of large databases and registries, and clinical therapeutic trials.

Keywords

Atrial Fibrillation Carotid Stenosis Stroke Subtype Stroke Registry North American Symptomatic Carotid Endarterectomy Trial 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Alter M, Sokel E, McCoy RL et al. (1985) Stroke in the Lehigh Valley: incidence based on a community-wide hospital register. Neuroepidemiology 4: 1–15PubMedCrossRefGoogle Scholar
  2. American-Canadian Cooperative Study Group (1983) Persantin aspirin trial in cerebral ischemia. Stroke 14: 99–103CrossRefGoogle Scholar
  3. Bamford J, Sandercook P, Dennis M et al. (1988) A prospective study of acute cerebrovascular disease in the community: the Oxfordshire community stroke project: 1981-1986. I. Methodology, demography, and incident cases of first-ever stroke. J Neurol Neurosurg Psych 51: 1373–1380CrossRefGoogle Scholar
  4. Bleich HL (1971) The computer as a consultant. New Engl J Med 284: 141–146PubMedCrossRefGoogle Scholar
  5. Bogousslavsky J, van Melle G, Regli F (1988) The Lausanne Stroke Registry: analysis of 1000 consecutive patients with first stroke. Stroke 19: 1083–1092PubMedCrossRefGoogle Scholar
  6. Boston Area Anticoagulation Trial for Atrial Fibrillation Investigators (1990) The effect of low-dose warfarin on the risk of stroke in patients with non-rheumatic atrial fibrillation. New Engl J Med 323: 1505–1511CrossRefGoogle Scholar
  7. Bousser MG, Eschwege E, Hagenau M et al. (1983) Controlled cooperative trial of secondary prevention of cerebral ischemic accidents caused by atherosclerosis, using aspirin and dipyridamole. Presse Med 12: 3049–3057PubMedGoogle Scholar
  8. Canadian Co-operative Study Group (1978) A randomized trial of aspirin and sulfinpyrazone in threatened stroke. New Engl J Med 299: 53–59CrossRefGoogle Scholar
  9. Caplan LR (1985) Stroke data banks, then and now. In: Courbier R (ed) Basis for a classification of cerebrovascular disease. Excerpta Medica, Amsterdam, pp 152–162Google Scholar
  10. Caplan LR, Hier DB, D’Cruz I (1983) Cerebral embolism in the Michael Reese Stroke Registry. Stroke 14: 530–536PubMedCrossRefGoogle Scholar
  11. Chambers BR, Donnan GA, Bladin PF (1983) Patterns of stroke. An analysis of the first 700 consecutive admissions to the Austin Hospital stroke unit. Aust NZ J Med 13: 57–64CrossRefGoogle Scholar
  12. Coull BM, Brockschmidt JK, Howard G et al. (1990) Community hospital-based stroke programs in North Carolina, Oregon, and New York IV. Stroke diagnosis and its relation to demographics, risk factors, and clinical status after stroke. Stroke 21: 867–873PubMedCrossRefGoogle Scholar
  13. Dutch TIA Trial Study Group (1991) A comparison of two doses of aspirin (30 mg vs. 283 mg a day) in patients after a transient ischemic attack or minor ischaemic stroke. New Engl J Med 325: 1261–1266CrossRefGoogle Scholar
  14. EC-IC Bypass Study Group (1985) Failure of extracranialintracranial arterial bypass to reduce the risk of ischemic stroke. New Engl J Med 313: 1191–1200CrossRefGoogle Scholar
  15. European Carotid Surgery Trialists Collaborative Group (1991) MRC European Carotid Surgery Trial: interim results for symptomatic patients with severe (70-99%) or with mild (1-29%) carotid stenosis. Lancet 337: 1235–1243CrossRefGoogle Scholar
  16. Foulkes MA, Wolf PA, Price TR et al. (1988) The Stroke Data Bank: design, methods, and baseline characteristics. Stroke 19: 547–554PubMedCrossRefGoogle Scholar
  17. Friday G, Lai SM, Alter M et al. (1989) Stroke in the Lehigh Valley: racial/ethnic differences. Neurology 39: 1165–1168PubMedGoogle Scholar
  18. Gorelick PB, Kelly MA (1992) Alcohol as a risk factor for stroke. Heart Dis Stroke 1: 255–258PubMedGoogle Scholar
  19. Gross CR, Kase CS, Mohr JP, Cunningham SC (1984) Stroke in South Alabama: incidence and diagnostic features. Stroke 15: 249–255PubMedCrossRefGoogle Scholar
  20. Hass WK, Easton JD, Adams HP et al. (1989) Ticlopidine Aspirin Stroke Study Group: a randomized trial comparing ticlopidine hydrochloride with aspirin for the prevention of stroke in high-risk patients. New Engl J Med 321: 501–507PubMedCrossRefGoogle Scholar
  21. Heyman A, Burch JG, Rosati R, Haynes C, Utley C (1979) Use of a computerized information system in the management of patients with transient cerebral ischemia. Neurology 29: 214–221PubMedGoogle Scholar
  22. Koudstaal PJ, van Gijn J, Staal A et al. (1986) Diagnosis of transient ischemic attacks: improvement of interobserver agreement by a check-list in ordinary language. Stroke 17: 723–728PubMedCrossRefGoogle Scholar
  23. Koudstaal P, Gerritsma JGM, van Gijn J et al. (1989) Clinical disagreement on the diagnosis of transient ischemic attacks: is the patient or the doctor to blame? Stroke 20: 300–311PubMedCrossRefGoogle Scholar
  24. Kunitz SC, Gross CR, Heyman A et al. (1984) The Pilot Stroke Data Bank: definition, design, and data. Stroke 15: 740–746PubMedCrossRefGoogle Scholar
  25. Mohr JP (1986) Editorial - Stroke data banks. Stroke 17: 171–172PubMedCrossRefGoogle Scholar
  26. Mohr JP, Caplan LR, Melski JW et al. (1978) The Harvard Cooperative Stroke Registry: a prospective registry of cases hospitalized with stroke. Neurology 28: 754–762PubMedGoogle Scholar
  27. North American Symptomatic Carotid Endarterectomy Trial (NASCET) collaborators (1991) Beneficial effect of carotid endarterectomy in symptomatic patients with high-grade carotid stenosis. New Engl J Med 325: 445–453CrossRefGoogle Scholar
  28. Pasteur L (1884) Address to the fraternal association of former students of the Ecole Centrale des Artes et Manufactures, ParisGoogle Scholar
  29. Shinar D, Gross CR, Mohr JP et al. (1985) Interobserver variability in assessment of the neurologic and history and examination in the Stroke Data Bank. Arch Neurol 42: 557–565PubMedGoogle Scholar
  30. Shinar D, Gross CR, Hier DB et al. (1987) Interobserver reliability in the interpretation of computed tomographic scans of stroke patients. Arch Neurol 44: 149–155PubMedGoogle Scholar
  31. Stroke Prevention in Atrial Fibrillation Investigators (1991) The Stroke Prevention in Atrial Fibrillation Study. Final results. Circulation 84: 527–539Google Scholar
  32. Wolf PA, D’Agostino RB, Belanger AJ, Kannel WB (1991a) Probability of stroke: a risk profile from the Framingham study. Stroke 22: 312–318PubMedCrossRefGoogle Scholar
  33. Wolf PA, Abbott RD, Kannel WB (1991b) Atrial fibrillation as an independent risk factor for stroke: The Framingham Study. Stroke 22: 983–988PubMedCrossRefGoogle Scholar
  34. Yatsu FM, Becker C, McLeroy KR et al. (1986) Community Hospital-based stroke programs: North Carolina, Oregon and New York. I: Goals, objectives and data collection procedures. Stroke 17: 276–284PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag London Limited 1995

Authors and Affiliations

  • Louis R. Caplan
    • 1
  1. 1.Department of NeurologyNew England Medical Center HospitalsBostonUSA

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