Medicine:Timeline of stroke
This is a timeline of stroke, describing especially major discoveries, developments and organizations concerning the disease.
Greek physician Hippocrates first recognizes stroke more than 2,400 years ago, calling the condition apoplexia. Hippocrates doesn't clarify that the condition actually happens in the brain, instead resolving into a "stagnation of the blood, whereby all the motion and action of the spirits is taken away", and that the motion is stopped by sharp humours, or a plethora (an excess of red blood cells or bodily humours). Galen (129 AD) accepts and develops the theory of Hippocrates, believing that apoplexy is caused by anything interfering with the flow of the vital spirit to the brain. The galenic theory persists for centuries.
Early modern times
United Kingdom physician William Harvey (1578–1657) publishes his theory on the circulation of the blood. Others, like Wepfer (1620–1695), still believe that apoplexy is caused by an obstruction in the path to the brain, suggesting that the brain did not receive enough "animal spirits". G.G.J. Robinson theorizes that there is a "plethora of fulness of blood", therefore bleeding is acceptable since it lessens the pressure on the "animal organs". Overall, the definition introduced by Hippocrates is still in use.
Although remnants of old dogma persist, the foundations have been laid for apoplexy to shed some ancient traditions based on symptomatic presentation and to evolve into a vascular disease based on clinico–pathological and patho–physiological correlates. Bonet publishes Sepulchretum sive Anatomica Practica, which becomes a prominent resource for physicians during most of the 18th century.
The earliest known stroke treatments start to happen, when surgeons begin performing surgery on the carotid arteries. Surgeons begin operating to reduce cholesterol buildup and remove blockages that could then lead to a stroke. Reports of successful closures of injuries to the carotid arteries are documented.
Early in the 20th century, most of the treatments for stroke patients are limited to rehabilitation after an acute stroke, and most patients are usually left with permanent and severe deficits. In the 1950s new techniques and therapies are developed to explore and modify the internal processes of cerebrovascular disease. In the 1960s carotid endarterectomy is greatly improved but is used mostly for stroke prevention and there is still no effective treatment after an acute stroke. In the 1970s aspirin is found to be very effective in stroke prevention. In the 1980s cigarette smoking is found to be a definite risk factor for stroke, and smoking cessation programs become very important. In the 1990s tissue plasminogen activator starts to be used for treatment of embolic or thrombotic stroke.
Today, rapid diagnosis is crucial for immediate treatment. Stroke remains the second most common cause of death worldwide, accounting for 6.7 million deaths in 2012. From 1990 to 2010, the age-standardised incidence of stroke significantly decreased by 12% in high-income countries, and increased by 12% in low-income and middle-income countries. In the same period, mortality rates showed a significant decrease in all countries.
|Year/period||Type of event||Event||Location|
|460 BC–370 BC||Development||Hippocrates first recognizes stroke and calls the condition apoplexia, which is a Greek term that stands for “struck down by violence.”|
|1620–1695||Discovery||Switzerland pathologist Johann Jakob Wepfer discovers that something disrupts the blood supply in the brains of peopled who died from apoplexy. In some of these cases, there was massive bleeding into the brain. In others, the arteries were blocked.|
|1679||Book||Switzerland physician Théophile Bonet publishes his Sepulchretum sive Anatomica Practica, a work that contains 3,000 autopsy cases, included 70 cases of apoplexy, being the most extensive collection of its time.||Geneva, Switzerland|
|1820||Development||English physician John Cooke writes: |
|1927||Development||Portuguese neurologist Egas Moniz successfully performs cerebral arteriograms for the study of cerebral tumors. For this work, Moniz receives the Nobel Prize in 1949.||Portugal|
|1928||Development||Apoplexy is divided into categories based on the cause of the blood vessel problem. This leads to the terms stroke or "cerebral vascular accident (CVA)."|
|1950||Organization||The National Institute of Neurological Disorders and Stroke (NINDS) is founded.||Bethesda, Maryland, United States|
|1954||Development||CAROTID endarterectomy is introduced as a procedure for the prevention of ischemic stroke distal to carotid-artery stenosis.|
|1972||Development||Xingnao Kaiqiao needling method is developed by Xue-min Shi for the treatment of stroke, especially ischemic stroke.||China|
|1973||Development||Melodic intonation therapy is developed as a technique in order to help stroke patients regain speaking skills.||Boston Veterans Affairs Hospital, Boston|
|1974||Development||The Glasgow Coma Scale is developed to be applied by emergency medical services to stroke or head injured patients.||University of Glasgow, Scotland|
|1975||Development||Fugl-Meyer Assessment is developed and later becomes the most established stroke motor measure. It is recommended for use in stroke rehabilitative trials.|
|1976||Discovery||Canadian Henry Barnett discovers that aspirin can prevent strokes in people at high risk, and can prevent recurrences in people who have had strokes.||Canada|
|1980-1985||Development||The National Institutes of Health Stroke Scale (NIHSS) is developed as a research tool to allow consistent reporting of neurological deficits in acute-stroke studies, particularly the early trials of thrombolysis and putative neuroprotectants.|
|1989||Organization||The International Stroke Society is established.|
|1990||Development||Stroke Impairment Assessment Set (SIAS), is developed as a comprehensive instrument to assess stroke impairment.|
|1990-1999||Development||The Los Angeles Prehospital Stroke Screen (LAPSS) is developed as a method for identifying potential stroke victims in a pre-hospital setting.|
|1994||Organization||The National Stroke Research Institute (Australia) is founded.||Heidelberg, Victoria (Australia)|
|1994||Development||Magnetic resonance imaging is introduced for stroke diagnosis.|
|1994||Organization||UCLA Stroke Center is founded.||Los Angeles , California|
|1996||Policy||The Food and Drug Administration (FDA) first approves use of tissue plasminogen activator for treatment of stroke.||United States|
|1996||Organization||The Congressional Heart and Stroke Coalition is founded as a bipartisan group of senators and representatives in order to raise awareness about the prevalence and severity of cardiovascular disease and the importance of research, prevention and treatment.||United States|
|1997||Development||The Cincinnati Prehospital Stroke Scale is developed as a system used to diagnose a potential stroke in a pre-hospital setting.||Cincinnati, United States|
|1998||Development||The Face Arm Speech Test (FAST) method is developed to help detect and enhance responsiveness to stroke victim needs.||United Kingdom|
|1999||Development||tPA drug, which can erase the effects of a stroke if administered within a few hours of the onset of symptoms, is approved for use.||Canada|
|2001||Development||MERCI Retriever is designed as a medical device to treat ischemic stroke.||University of California, Los Angeles|
|2001||Organization||The Canadian Stroke Network is founded.|
|2001||Organization||A stroke unit is established for the first time in China, in the Department of Neurology of Beijing Tiantan Hospital.||Beijing|
|2002||Report||Stroke is found to be the sixth largest cause of disability at a worldwide level.|
|2004||Organization||The World Stroke Federation is established.|
|2005||Development||First use of embryonic stem cells in stroke research is performed.|
|2006||Organization||The World Stroke Organization is established through the merger of the International Stroke Society and the World Stroke Federation.||Geneva, Switzerland|
|2008||Development||The Kurashiki Prehospital Stroke Scale is developed for identifying thrombolytic candidates in acute ischemic stroke.|
|2012||Development||Helsinki model of stroke unit is established as a best logistic structure to use thrombolytic therapy in acute ischemic stroke. DTN [door to needle time] is reduced to below 20 minutes|
|2014/2015||Discovery||Mechanical trombectomy widely introduced as a best treatment for large artery strokes|
|2016||Discovery||Immediate aspirin after mini-stroke is found to substantially reduce risk of major stroke.||Oxford University|
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