Volume 70 Number 1 January 2003	back to contents

Assistant Professor of Neurology, Columbia University, New York, NY.

Address all correspondence to Dr. Mitchell S.V. Elkind, Neurological Institute, 710 West 168th Street, New York, NY 10032.

Funding: NINDS K23 NS42912

Some of the material was presented at the Mount Sinai School of Medicine Geriatric Medicine Update and Board Review Course, New York, NY, on October 8, 2001.

ABSTRACT

Stroke is one of the oldest but least understood diseases, and it is one of the major public health problems facing the elderly. Recent epidemiological investigations have found that the incidence of stroke has been underestimated by about 50%, and that the burden of disease is highest in minority populations. Recent clinical and basic neuroscience research indicates that stroke is neither unpredictable nor irreversible. Many risk factors for stroke are readily identifiable, and evidence-based treatment may be used to reduce the likelihood of stroke among those at risk. Rapid diagnosis and evaluation of stroke and transient ischemic attack and their treatment, including surgery, anticoagulation, antiplatelet and other medical therapies, reduce the chance of recurrence. More aggressive treatment of blood pressure, even among patients who are not necessarily hypertensive, may also reduce the risk of future strokes. Once ischemic stroke has occurred, emergent therapy using thrombolysis may significantly reduce disability, even among the elderly. This review presents an update on definitions of stroke and its subtypes, stroke epidemiology, and the results of recent studies of stroke prevention and acute treatment.

KEYWORDS

Cerebrovascular disorders, clinical trials, epidemiology, elderly, stroke.

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