Transforming the management of stroke

Effective strategies for improving outcomes require efficient triage and interdisciplinary cooperation

When I commenced work as a junior neurologist, one of the first patients admitted under my care was a woman with a history of atrial fibrillation who presented acutely with a major stroke in her dominant hemisphere, causing aphasia and a dense right-sided hemiparesis. After examining the woman, I explained to her son — one of my colleagues — that the prognosis was poor; should his mother survive, she would probably be left with significant long term disability. He responded that he had just read a report in Nature about removing clots from blood vessels to reperfuse the brain during an acute stroke. The approach seemed rational, although it appeared to rest more in the realm of science fiction than something that would be of practical clinical use anytime soon.