History and evolution of cerebrovascular disease: a global challenge

Abstract

Cerebrovascular disease (CVD) has a documented history dating back more than 2 400 years. Hippocrates was one of the first to recognize stroke, although knowledge about its anatomy and treatment was limited. In 1550 BC, the Smith Papyrus first described stroke, and in 1620 Jacob Wepfer identified the vascular causes of stroke. During the 19th and early 20th centuries, the management of CVD was primitive and consisted of bloodletting and sedation. Advances in pathologic anatomy during the 20th century allowed classification of stroke subtypes and a better understanding of its etiology. However, the absence of diagnostic technologies made treatment difficult, resulting in permanent disabilities and limited social reintegration. In recent decades, new therapeutic methods, such as nanotechnology, have improved the prevention and rehabilitation of these patients. CVD continues to be a global challenge due to its high prevalence, mortality and associated costs. It represents one of the leading causes of disability and death, especially in older adults. According to the WHO, 15 million cases of stroke are reported each year, with 5,5 million deaths and as many with permanent disabilities. Although its incidence has decreased in developed countries, in developing regions it continues to increase due to economic and demographic factors. Primary prevention remains the key to mitigating its impact.