New Cerebrovascular Disease Definition Needed to Further Stroke Prevention
Treatment for brain ischemia should be based on cause, not on an archaic definition of the condition, said a world-leading authority on stroke.
"The current and old clinical definition for stroke is outdated and has meant patients have not received the treatment they need to prevent it," said Louis R. Caplan, M.D., professor of neurology, Harvard Medical School and senior neurologist and director of the Stroke Service at Beth Israel Deaconess Medical Center, Boston.
Caplan founded the Harvard Cooperative Stroke Registry, the first stroke registry of its kind, more than 30 years ago. He will co-moderate the symposium "Are We Ready Now for a New Definition for Cerebrovascular Disease?" from 9:15 to 10:45 a.m. today in Grand Ballroom C3. Lawrence K. S. Wong, M.D., Chinese University of Hong Kong, will serve as co-moderator.
Caplan will open with a historical perspective on how cerebrovascular disease categories have been defined.
"We need to move away from the definition of clinical stroke and not be so bound by it, especially as it pertains to a 24-hour time frame, which has been shown to be inaccurate," he said.
"Patients presenting with transient ischemic attacks, regardless of how short the attack, often do have brain damage, as is now known with the use of MRIs and other imaging techniques. TIAs should be treated with the same urgency as a full-blown stroke."
Telemedicine, Caplan added, also will help further treatment of brain ischemia.
"In cities, patients most often go to a recognized stroke treatment center," he said. "However, patients living in peripheral areas will benefit from implementation of stroke telemedicine to help address barriers in stroke care."
Following Caplan's presentation, Gregory W. Albers, M.D., Stanford University School of Medicine, Palo Alto, Calif., will share "The New Definition for Transient Ischemic Attack (TIA)," followed by a presentation by Jeffrey L. Saver, M.D., University of California, Los Angeles, on "The New Definition for Brain Infarction." Scott E. Kasner, M.D., Hospital of the University of Pennsylvania, Philadelphia, will conclude by discussing "The New Definition of Stroke."
Caplan is former chairman of the AHA Stroke Council and a recipient of the AHA Distinguished Achievement Award. He has authored or edited more than 35 books, including the landmark textbook, "Caplan's Stroke: A Clinical Approach," now in its fourth edition. He is co-author, along with Adrian J. Goldszmidt, M.D., of the just-released second edition of "Stroke Essentials 2010."