EXTENSION OF FUNDAMENTAL STROKE RESEARCH INTO CLINICAL CARE

Clinical efforts in stroke prevention have measurably reduced the inci dence of stroke in persons experiencing a number of risk factors. Clin ical efforts to reduce stroke size once the process starts, however, h ave been disappointing. A variety of agents aimed at blocking the effe cts of excitotoxic neurotransmitters or interfering with intracellular calcium entry have been tested but with little success on clinical ou tcome. Satisfactory explanation of the paradox between animal and clin ical outcome studies has not been forthcoming. Accordingly, clinical i nvestigators are exploring the potential value of surgical craniectomy in efforts to improve the presently devastated outcome that marks the course of severe, large acute cerebral infarctions. (C) 1997 Wiley-Li ss, Inc.