Introduction

This book takes what is known as a problem-orientated approach. The problems posed by stroke patients are discussed in the sort of order that they are likely to present themselves. Stroke has been somewhat of a Cinderella area of medicine, at least with respect to the other two of the three most common fatal disorders in the developed world: coronary heart disease and cancer. Catheter angiography is giving way to non-invasive imaging. Magnetic resonance techniques are racing ahead of the evidence as to how they should be used in routine clinical practice. For better or worse, coiling cerebral aneurysms is replacing clipping. Neuroprotection is even less likely to be an effective treatment for ischaemic stroke than it was in the 1990s. And it is not just acute stroke that needs urgent attention nowadays, transient ischaemic attacks must be assessed and managed very quickly to minimize the early high risk of stroke.