Louis R. Caplan (editor) - Stroke.

SERIES CO-EDITORS-IN-CHIEF

Lawrence C. Newman, MD

Director of the Headache Institute

Department of Neurology

St. Lukes-Roosevelt Hospital Center

New York, New York

Morris Levin, MD

Co-director of the Dartmouth Headache Center

Director of the Dartmouth Neurology Residency Training Program

Section of Neurology

Dartmouth Hitchcock Medical Center

Lebanon, New Hampshire

OTHER VOLUMES IN THE SERIES

Headache and Facial Pain

Peripheral Nerve and Muscle Disease

Pediatric Neurology

Stroke

Epilepsy

Neuro-ophthalmology

Neuroimmunology

Pain

Neuroinfections

Emergency Neurology

Cerebrovascular Disease

Movement Disorders

Neurogenetics

Neurotology

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Published in the United States of America by Oxford University Press

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Oxford University Press 2016

First Edition published in 2010

Second Edition published in 2016

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Library of Congress Cataloging-in-Publication Data

Names: Caplan, Louis R., editor. | Lioutas, Vasileios-Arsenios, editor.

Title: Stroke / [edited by] Louis R. Caplan, Vasileios-Arsenios Lioutas.

Other titles: Stroke (Caplan) | What do I do now?

Description: Second edition. | Oxford ; New York : Oxford University Press, 2016. |

Series: What do I do now? | Includes bibliographical references and index.

Identifiers: LCCN 2015042321 | ISBN 9780190497255 (pbk. : alk. paper)

Subjects: | MESH: StrokediagnosisCase Reports. | StroketherapyCase Reports.

Classification: LCC RC388.5 | NLM WL 356 | DDC 616.8/1dc23

LC record available at http://lccn.loc.gov/2015042321

This material is not intended to be, and should not be considered, a substitute for medical or other professional advice. Treatment for the conditions described in this material is highly dependent on the individual circumstances. And, while this material is designed to offer accurate information with respect to the subject matter covered and to be current as of the time it was written, research and knowledge about medical and health issues is constantly evolving and dose schedules for medications are being revised continually, with new side effects recognized and accounted for regularly. Readers must therefore always check the product information and clinical procedures with the most up-to-date published product information and data sheets provided by the manufacturers and the most recent codes of conduct and safety regulation. The publisher and the authors make no representations or warranties to readers, express or implied, as to the accuracy or completeness of this material. Without limiting the foregoing, the publisher and the authors make no representations or warranties as to the accuracy or efficacy of the drug dosages mentioned in the material. The authors and the publisher do not accept, and expressly disclaim, any responsibility for any liability, loss or risk that may be claimed or incurred as a consequence of the use and/or application of any of the contents of this material.

Vasileios-Arsenios Lioutas

Mark McAllister

Merritt W. Brown

Marc Bouffard

Shruti Sonni

Meg Van Nostrand

Mark McAllister

Bart Chwalisz and Elorm Avakame

D. Eric Searls

D. Eric Searls

Lester Y. Leung

Sourabh Lahoti

Sourabh Lahoti

Louis R. Caplan

Vasileios-Arsenios Lioutas

Vasileios-Arsenios Lioutas

Luciana Catanese

Vasileios-Arsenios Lioutas

Vasileios-Arsenios Lioutas

Vasileios-Arsenios Lioutas

Bart Chwalisz

Vasileios-Arsenios Lioutas

Vasileios-Arsenios Lioutas

Vasileios-Arsenios Lioutas

Vasileios-Arsenios Lioutas

Vasileios-Arsenios Lioutas

Vasileios-Arsenios Lioutas

C. Miller Fishers aphorism, that one learns neurology stroke by stroke, is probably all too familiar to most neurologists by now, but it is more than just a clever quote. If an aphorism is, in Karl Krauss words, either a half-truth or a truth and a half, then it certainly errs on the side of the latter. Historically, clinicopathologic observations of stroke-related brain lesions and the loss of function of the affected areas were the main source of information on the normal function of these areas. Even in the current era of abundantly available diagnostic imaging, diagnosis and anatomic localization of stroke symptoms and syndromes remain critical, and they can be an excellent window into clinical neuroanatomy for medical students and neurology residents. Acute stroke management and secondary prevention have been revolutionized during the past two decades, which makes stroke a lot more exciting and complex than a simple exercise in applied neuroanatomy.

Stroke is a heterogeneous disease and a detailed, comprehensive review would exceed the scope of this book. Our goal is dual: to highlight how intriguing the diagnostic process can be in real-life encounters and to offer management insight that, hopefully, proves helpful for the practicing clinician. In an effort to make the read more engaging, we made several changes from the first edition. Instead of refining the cases discussed in the first edition, we replaced most of them with new ones. Readers are challenged with a mixture of bread-and-butter cases, and more peculiar and idiosyncratic ones. Although the first kind is encountered more frequently, the latter spark the imagination and can be a perfect antidote to the mental fatigue brought by a grueling, long day at work in the middle of a Boston winter. We also made changes in the format, avoiding disclosure of the diagnosis until the discussion, in an effort to challenge readers to think diagnostically. Chapter titles have been left intentionally vague so as not to give away the diagnoses and, although they range from the prosaic to the more creative, readers will realize they are not chosen thoughtlessly. We have added several references for further reading at the end of each chapter and we hope they help readers to delve further into the details and implications of the case at hand.

All chapter authors are currently members of the Beth Israel Deaconess Medical Center Neurology Department or have trained in our Stroke Fellowship with us. We reviewed and edited all cases carefully for a minimum of uniformity of dialectic style, but we mostly allowed for variations in narrative-style individuality. We hope this adds to the appeal of the book and makes it more direct and enjoyable.