title: Chapter 27: a history of cerebrovascular disease.
abstract: Stroke is central to the history of cerebrovascular disease. References to this condition already appear in the Hippocratic corpus, referred to as apoplexy, which was defined by the clinical presentation: a sudden collapse, a loss of consciousness, a lack of movement, and included a variety of pathologies. A humoral imbalance was seen as the causation. In the 17th century, Johannes Wepfer, a Swiss physician, first demonstrated that apoplexy was caused by an intracranial hemorrhage; Thomas Willis, an English anatomist, explored the role of the cerebral arteries. Stroke became a cerebrovascular disease. By the 19th century, based on extensive clinico-pathological correlates initiated at the Paris Medical School, a vascular basis was firmly established and a range of pathologies determined. Apoplexy was considered too imprecise, and the term abandoned in favor of the term "cerebro-vascular accident" and latterly stroke. Although physicians of the 19th century utilized a wide variety of therapies in the treatment of stroke, with particular emphasis on blood letting, therapeutic nihilism dominated stroke management well into the 20th century. Following the mid 20th century work by C. Miller Fisher, with the recognition of the importance and the therapeutic implication of the carotid artery in stroke, the specialty of stroke medicine came into being. Therapeutic nihilism was replaced by an increasing armamentarium of therapeutic interventions.
authors.affiliation: Department of Neurology, Royal North Shore Hospital, St. Leonards, Australia. cstorey@nsccahs.health.nsw.gov.au
authors.forename: Catherine E
authors.initials: CE
authors.lastname: Storey
authors.forename: Hans
authors.initials: H
authors.lastname: Pols
mesh_terms: D002561:Cerebrovascular Disorders / Q000266:history* / Q000473:pathology / Q000503:physiopathology; D049668:History, 15th Century; D049669:History, 16th Century; D049670:History, 17th Century; D049671:History, 18th Century; D049672:History, 19th Century; D049673:History, 20th Century; D049690:History, Ancient; D049691:History, Medieval; D006801:Humans