| 1920s |
-
Contrast angiography developed.
|
| 1940s |
-
Indicator dilution technique used to measure cerebral flow metabolism.
|
| 1950s |
-
Recognition that carotid bifurcation disease could cause cerebral infarction,
often preceded by transient ischemic attack (TIA) as a warning symptom.
-
First carotid endarterectomy performed.
-
Prosthetic heart valves introduced to patients with rheumatic heart disease
to lessen the risk for embolic stroke.
|
| 1960s |
-
Severe hypertension identified as a treatable risk factor for stroke.
-
Doppler ultrasonography developed.
-
Start of the real decline in the incidence of and mortality from stroke.
|
| 1970s |
-
Demonstration that aspirin effective in preventing stroke.
-
Development of computerized tomography (CT) that radically changes early
diagnosis of ischemic or hemorrhagic stroke.
-
Recognition of the management of risk factors for stroke associated with
major decline in stroke mortality.
-
PET scanning provides important information about brain metabolism.
|
| 1980s |
-
Demonstration that early aneurysm surgery incorporating advances in microsurgery
and neuroanesthesia effective in improving outcome after subarachnoid hemorrhage.
-
Prospective randomized trial methodology perfected.
-
Development of MRI that further improved evaluation of persons with cerebrovascular
disease.
-
Interventional neuroradiology allows for more aggressive approaches to
treatment of arterial lesions.
-
Ticlopidine,another antiplatelet drug, is demonstrated to be effective
in lessening the risk of stroke.
-
Transcranial Doppler applied clinically.
-
Increased emphasis on identifying the risk factors for stroke in women
and minorities begin.
-
Increased stroke due to drug abuse recognized.
-
Cigarette smoking is established conclusively as a major risk factor for
stroke; and that cessation produces a significant risk reduction by two
years, and to that of nonsmokers by five years.
-
Demonstration that the treating isolated systolic hypertension in the elderly
reduces stroke risk.
|
| 1990s |
-
Carotid endarterectomy is proven to be effective in preventing stroke among
patients with severe stenosis.
-
Oral anticoagulants and aspirin are shown to be very effective in lessening
the risk of stroke among persons with atrial fibrillation.
-
Oral anticoagulants superior to aspirin in preventing further strokes when
a stroke patient has atrial fibrillation
-
Conclusive evidence that specialized stroke centers decrease mortality
and improve outcome for stroke.
-
Secondary prevention trials emphasise the role of reducing blood pressure
and reducing cholesterol.
-
The FDA approved the use of the thrombolytic drug, tissue plasminogen activator
(TPA), to treat stroke in the first three hours.
-
The addition of dipyridamole to low-dose aspirin increases the apparent
protection of either anti-platelet drug in secondary prevention.
|
