ADVANCES in the acute treatment of stroke are driving some major changes in its management. The ultimate goal, now deemed within reach, is a significant reduction in the neurologic deficit that is frequently the sequel to acute stroke: the patient survives but is severely incapacitated.
At the National Symposium on Rapid Identification and Treatment of Acute Stroke, held last month by the National Institute of Neurological Disorders and Stroke (NINDS), Bethesda, Md, some new directions emerged. One speaker cited the recommendations of the Pan-European Consensus Meeting on Stroke Management held in Helsingborg, Sweden, in November 1995 as goals that could be usefully adopted by the United States. They include the following:
• To reduce the fatality rate in stroke patients who survive acute stroke to below 20%;
• To reduce the mortality rate from recurrent vascular events, including myocardial infarction, to less than 40% in the first 2 years after