Feature Articles: Strokes

Guest Editor's Note

Scott Silliman, M.D. is Director, Comprehensive Stroke Program at University of Florida Health Science Center and Assistant Professor of Neurology, University of Florida College of Medicine

Stroke is a common, deadly, and disabling disorder. Fortunately, significant strides are being made in our understanding of stroke epidemiology and pathophysiology. These advances have translated into more effective primary and secondary preventive treatment strategies. Clinical stroke practices are now supported by a foundation of evidence-based therapies. The introduction of tissue plasminogen activator into stroke therapeutics has ushered in an age of interventional stroke therapy.

Within the medical community, attitudes toward stroke are changing. Therapeutic nihilism is being replaced by optimism. Exciting new developments in stroke treatment have also heightened public awareness that acute stroke is a medical emergency.

This issue of Jacksonville Medicine is devoted to selected aspects of cerebrovascular disease and stroke. Dr. Meschia and Dr. Brott, provide a review of Lipids and Ischemic Stroke. Hypercholesterolemia is a well known risk factor for coronary artery disease but is only now emerging as a risk factor for ischemic stroke. In Stroke Prevention, Dr. Rubino insightfully reviews primary and secondary prevention of stroke. Stroke is not an illness that is restricted to the adult population. Dr. Abrams' article, is an informative review of Childhood Strokes: Evaluation and Management. Acute Stroke Therapy with tPA is an overview of the clinical applications of tissue plasminogen activator. Dr. Booth's article, Endovascular Intervention In Acute Stroke and Occlusive Vascular Disease, provides a glimpse of intra-arterial thrombolysis, an emerging therapy that may have definite clinical indications in the near future. Extracranial to intracranial bypass is a procedure that is undergoing reassessment as a potential treatment of carotid artery occlusive disease. Dr. Link's and Ms. Herzog's article Extracranial-Intracranial Bypass: Technical Achievement, Controversies, and Indications in the Treatment of Ischemic Stroke, is an excellent review of the history of this procedure and its potential current indications.

I have enjoyed working with my colleagues to produce this issue of Jacksonville Medicine. Management issues concerning stroke and cerebrovascular disease are diverse and often complex. The topics for this issue were chosen to provide an overview of new developments in stroke management.

Feature Articles: Strokes

Guest Editor's Note

Scott Silliman, M.D. is Director, Comprehensive Stroke Program at University of Florida Health Science Center and Assistant Professor of Neurology, University of Florida College of Medicine

Jacksonville Medicine / November, 1998