[Definition and treatment of stroke over the centuries]

Wiad Lek. 2017;70(5):982-987.
[Article in Polish]

Abstract

Stroke was already diagnosed in the ancient times. For hundreds of years the treatment of this disease has changed radically. According to the current WHO definition, stroke is a clinical syndrome caused by focal or generalized brain injury that lasts more than 24 hours or leads to death and has no other cause than vascular. Stroke constitutes a big social and economic problem, as it can lead to death or disability. In the highly developed countries stroke is the third most common cause of adult deaths, the second leading cause of dementia, and the most common cause of disability. The consequences of stroke also include epilepsy and depression. In the twentieth century, stroke was only treated symptomatically and rehabilitation was limited to passive exercises. The first breakthrough in ischemic stroke therapy was the introduction of aspirin (ASA), followed by intravenous thrombolysis using recombinant tissue plasminogen activator (rtPA), initially available in our country only in the drug programs, and since 2009 it has been reimbursed by the National Health Fund (NFZ). Gradually invasive stroke treatment has been developed. Mechanical thrombectomy is currently only performed in selected centers, giving hope for more effective stroke treatment. The purpose of this work was to show how stroke treatment has changed over the centuries.

Keywords: intravenous trombolysis; mechanical trombectomy; acetylsalicylic acid; history of medicine; stroke.

Publication types

  • Review

MeSH terms

  • Brain Ischemia / therapy*
  • Combined Modality Therapy
  • Fibrinolytic Agents / therapeutic use
  • Humans
  • Stroke / therapy*
  • Stroke Rehabilitation*
  • Thrombectomy / methods
  • Thrombolytic Therapy / methods
  • Tissue Plasminogen Activator / therapeutic use

Substances

  • Fibrinolytic Agents
  • Tissue Plasminogen Activator