LONG-TERM EFFECTS OF STROKE

Abstract

S. L. Small and A. SolodkinNeurology and Brain Research Imaging Center, University of Chicago, Chicago, IL, USA LONG‐TERM EFFECTS OF STROKE Edited by Julien Bogousslavsky 2002. Monticello, NY: Marcel Dekker, Inc. Price $175. pp. 344. ISBN 0–8247–0624–2 A serious shortcoming in current neurological practice is the post‐acute care we are able to provide to patients with stroke. Whereas tremendous research has recently changed the ways in which neurologists view acute ischaemic stroke, with a number of thrombolytic and neuroprotective approaches now available and others under investigation, little attention is paid to patients following maximal acute care. Progress in the intensive care of such patients in specialised critical care neurology units has also improved outcomes, as has good aetiological diagnosis (e.g. cardiogenic embolism, carotid stenosis) and secondary prevention. However, after discharge from the intensive care unit and the inpatient neurology ward, with maximal acute treatment and perhaps secondary prevention tailored to a specific aetiological diagnosis, patients are sent off to the care of physiatrists and therapists for various re‐educational programs that are not motivated by the goals of brain recovery or purposeful neural remodelling. Furthermore, practising neurologists pay little attention to patients at this stage of stroke recovery, despite the fact that these patients have a serious neurological illness (they have the same illness as before, just as do patients with amyotrophic lateral sclerosis or Alzheimer’s disease or Parkinson’s disease), and the fact that they have marked neurological signs and symptoms. A particular irony of improved acute stroke care is the increased survival of patients with such problems. In advanced countries, stroke is the primary cause of disability in adults. A recent book, targeted at clinical neurologists, aims to reduce this knowledge gap regarding the long‐term effects of stroke. This book, edited by the well‐known stroke neurologist Julien Bogousslavsky of Lausanne, contains twelve chapters focusing on various aspects of assessment and prognosis of stroke sequelae, including several chapters …