The Contribution of Multicenter Trials to Stroke Prevention and Treatment

Abstract

Until the second half of this decade, neurologists interested in stroke felt little need for critical studies evaluating therapeutic measures. Neither stroke prevention nor specific treatment of patients who had signs of infarction offered promise. Detailed study of individual patients was of importance mainly to assess the probable prognosis. The imaging methods of the day were inexact, uncomfortable, and not without risk. The situation has changed: there has been a dramatic decline in the occurrence of, and mortality due to, stroke; primary prevention measures collectively appear to have brought about this reduction; some effective secondary prevention measures are available now, and other new ones look promising; certain measures to reduce the brain edema associated with infarction have been found to be ineffective, if not hazardous, and we are struggling with uncertainties about the others; putative measures for brain resuscitation are undergoing animal and early clinical trials; the possibility of actively