Recent advances in the diagnosis and treatment of stroke

Stroke is defined as an abnormality in brain function resulting from disruption of cerebral circulation. It is the third leading cause of death in the United States and the primary cause of long-term disability. The economic burden of stroke will only increase as the population ages, making prevention and treatment of stroke one of the most important public health issues of the upcoming millennium. New therapies for the treatment of acute stroke, especially thrombolysis, have turned what was once considered an inevitable deficit into a potentially treatable illness. It is increasingly important for all physicians to be able to identify symptoms of cerebral ischemia. Neurons have a very limited tolerance for ischemia, making the rapid evaluation and diagnosis of stroke critical. This is particularly relevant for the ophthalmologist, who may be the first physician to see individuals presenting with visual deficits. Trials are underway to look specifically at central retinal artery and basilar artery ischemia and their response to thrombolytic therapy. This review will focus on description of recent advances in treatment and diagnosis of stroke, including thrombolytic trials and the expanding role of neuroimaging.