Stroke in the 21st century

December 19, 2002

In the first issue of 2003, TLN examines stroke epidemiology and stroke trials. In their review, Valery Feigin and co-authors provide an overview of population-based studies of incidence, prevalence, mortality, and case-fatality of stroke based on studies reported between 1996 and 2002. From their analysis the authors conclude, "the burden of stroke is high and is likely to increase in future decades as a result of demographic and epidemiological transitions in populations". In an accompanying personal view, Ken Lees, Graeme Hankey, and Werner Hacke discuss the designs and results of all controlled trials of treatments for ischaemic stroke, and try to identify opportunities to improve future treatment assessment.


In a Reflection & Reaction article, John Greenwood and colleagues discuss the evidence supporting a role for statins--such as lovastatin and atorvastatin--in the treatment of multiple sclerosis by the prevention of CNS leucocyte accumulation. Since the mechanism of action of statins differs from that of currently approved treatments, there may be some benefit in a combination approach.


Mild cognitive impairment is a recently adopted term to describe the transition between healthy ageing and dementia. In a review article, Charles DeCarli discusses the prevalence, pathophysiology, prognosis, and possibilities for the treatment of this condition. "Current estimates suggest that many people have various cognitive impairments that will substantially increase their risk of developing dementia, hence the urgent need to identify and treat these disorders", he writes.


  • Immunotherapy for autoimmune neuromuscular disorders
  • Cellular biology of epileptogenesis


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