Cerebrovascular Disease and Stroke

  • Louis Caplan


Stroke is a problem of major importance in the geriatric age group. In 1984 one-half million Americans had a stroke, more than 150,000 died of stroke, and there were 2 million stroke survivors. A great majority of strokes occur in individuals older than 65 years of age. During 1980, death rates from stroke for men and women aged 65 to 69 years were more than five times higher than for individuals aged 50 to 54 years. And for individuals older than 85 years of age, the stroke death rate was over 50 times higher than for individuals in their 50s.1 In nearly all age groups, men have more strokes and more stroke deaths than women.


Atrial Fibrillation Internal Carotid Artery Vertebral Artery Subclavian Artery Basilar Artery 
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  1. 1.
    Wolf PA, Kannel WB, McGee D. Epidemiology of strokes in North America. In: Barrett HJ, Mohr JP, Stein BM, et al., eds. Stroke, Pathophysiology, Diagnosis, and Management. New York: Churchill-Livingstone; 1986: 19–29.Google Scholar
  2. 2.
    Anderson GL, Whisnant JP. A comparison of trends in mortality from stroke in the United States and Rochester, Minnesota. Stroke. 1982; 13: 804–809.PubMedCrossRefGoogle Scholar
  3. 3.
    Caplan LR, Stein RW. Subarachnoid Hemorrhage in Stroke: A Clinical Approach. Stoneham, MA: Butterworths; 1986; 231–260.Google Scholar
  4. 4.
    Caplan LR. Stroke, A Clinical Approach. 2nd ed. Boston: Butterworth-Heinemann; 1993.Google Scholar
  5. 5.
    Phillips LH, Whisnant JP, O’Fallon M, et al. The unchanging pattern of subarachnoid hemorrhage in a community. Neurology. 1980; 30: 1034–1040.PubMedCrossRefGoogle Scholar
  6. 6.
    Sacco RL, Wolf PA, Bharucha N, et al. Subarachnoid hemorrhage: natural history, prognosis and precursive factors in the Framingham study. Neurology. 1984; 34: 847–854.PubMedCrossRefGoogle Scholar
  7. 7.
    Parkarinen S. Incidence, etiology, and prognosis of primary subarachnoid hemorrhage: a study based on 589 cases diagnosed in a defined urban population during a defined period. Acta Neurol Scand. 1967; 43 (suppl 29): 1–128.Google Scholar
  8. 8.
    Fisher CM, Kistler JP, Davis JM. Relation of cerebral vasospasm to subarachnoid hemorrhage visualized by computed tomographic scanning. Neurosurgery. 1980; 6: 1–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Caplan LR. Computed tomography and stroke. In: McDowell F, Caplan LR, eds. Cerebrovascular Survey Report for the National Institute of Neurological and Communicative Disorders and Stroke. Washington; 1985: 61–74.Google Scholar
  10. 10.
    Caplan LR, Flamm ES, Mohr JP, et al. Lumbar puncture and stroke. Stroke. 1987; 18: 540A - 544A.Google Scholar
  11. 11.
    Heros RC, Zervas NT, Varsos V. Cerebral vasospasm after subarachnoid hemorrhage: an update. Ann Neurol. 1983; 14: 599–608.PubMedCrossRefGoogle Scholar
  12. 12.
    Caplan LR. Intracerebral hemorrhage revisited. Neurology. 1988; 38: 624–627.PubMedCrossRefGoogle Scholar
  13. 13.
    Kase CS, Caplan LR. Intracerebral Hemorrhage. Boston: Butterworth-Heinemann; 1994.Google Scholar
  14. 14.
    Fisher CM. Pathological observations in hypertensive cerebral hemorrhages. J. Neuropathol Exp Neurol. 1971; 30: 536–550.PubMedCrossRefGoogle Scholar
  15. 15.
    Caplan LR, Mohr JP. Intracerebral hemorrhage: an update. Geriatrics. 1978; 33: 42–52.PubMedGoogle Scholar
  16. 16.
    Kase C, Robinson K, Stein R, et al. Anticoagulant-related intracerebral hemorrhage. Neurology. 1985; 35: 943–948.PubMedCrossRefGoogle Scholar
  17. 17.
    Gilbert J, Vinters J. Cerebral amyloid angiopathy; incidence and complications. Stroke. 1983; 14: 915–928.PubMedCrossRefGoogle Scholar
  18. 18.
    Mohr JP, Caplan LR, Melski J, et al. The Harvard Cooperative Stroke Registry: a prospective registry. Neurology. 1978; 29: 754–762.CrossRefGoogle Scholar
  19. 19.
    Caplan LR, D’Cruz I, Hier DB, et al. Atrial size, atrial fibrillation, and stroke. Ann Neurol. 1986; 19: 158–161.PubMedCrossRefGoogle Scholar
  20. 20.
    Albers GW, Atwood JE, Hirsh J, et al. Stroke prevention in nonvalvular atrial fibrillation. Ann Intern Med. 1991; 115: 727–736.PubMedGoogle Scholar
  21. 21.
    Fairfax AJ, Lambert CD, Leatham A. Systemic embolism in chronic sinoatrial disorder. N Engl J Med. 1976; 295: 190–193.PubMedCrossRefGoogle Scholar
  22. 22.
    Fisher CM, Perlman A. The nonsudden onset of cerebral embolism. Neurology. 1967; 17: 1025–1032.PubMedCrossRefGoogle Scholar
  23. 23.
    Caplan LR, Hier DB, D’Cruz I. Cerebral embolism in the Michael Reese Stroke Registry. Stroke. 1983; 14: 530–536.PubMedCrossRefGoogle Scholar
  24. 24.
    DeWitt LD, Pessin MS, Pandian NG, et al. Benign disappearance of ventriular thrombus after embolic stroke. Stroke. 1988; 19: 393–396.PubMedCrossRefGoogle Scholar
  25. 25.
    Lechat P, Mas JL, Lascault G, et al. Prevalence of patient foramen ovale in patients with stroke. N Engl J Med. 1988; 318: 1148–1152.PubMedCrossRefGoogle Scholar
  26. 26.
    Petersen P, Godtfredsen J, Boysen G, et al. Placebo-controlled randomized trial of warfarin and aspirin for prevention of thromboembolic complications in chronic atrial fibrillation: The Copenhagen AFASAK Study. Lancet. 1989; 1: 175–179.PubMedCrossRefGoogle Scholar
  27. 27.
    The Stroke Prevention in Atrial Fibrillation (SPAF) Investigators. The stroke prevention in atrial fibrillation study: final results. Circulation. 1991; 84: 527–539.CrossRefGoogle Scholar
  28. 28.
    The Boston Area Anticoagulation Trial for Atrial Fibrillation (BAATAF) Investigators. The effect of low-dose warfarin on the risk of stroke in patients with nonrheumatic atrial fibrillation. N Engl J Med. 1990; 323: 1505–1511.CrossRefGoogle Scholar
  29. 29.
    Ezekowitz MD, Bridgers SL, James KE, et al. Warfarin in the prevention of stroke associated with nonrheumatic atrial fibrillation. N Engl J Med. 1992; 327: 1406–1412.PubMedCrossRefGoogle Scholar
  30. 30.
    Albers GW, Sherman DG, Gress DR, et al. Stroke prevention in nonvalvular atrial fibrillation: a review of prospective randomized trials. Ann Neurol. 1991; 30: 511–518.PubMedCrossRefGoogle Scholar
  31. 31.
    Caplan LR. Prevention of cardioembolic stroke. Heart Dis Stroke. 1994; 3: 297–303.PubMedGoogle Scholar
  32. 32.
    EAFT (European Atrial Fibrillation Trial) Study Group. Secondary prevention in nonrheumatic atrial fibrillation after transient ischaemic attack or minor stroke. Lancet. 1993; 342: 1255–1262.Google Scholar
  33. 33.
    Amarenco P, Duyckaerts C, Tzourio C, et al. The prevalence of ulcerated plaques in the aortic arch in patients with stroke. N Engl J Med. 1992; 326: 221–225.PubMedCrossRefGoogle Scholar
  34. 34.
    Amarenco P, Cohen A, Tzourio C, et al. Atherosclerotic disease of the aortic arch and the risk of ischemic stroke. N Engl J Med. 1994; 331: 1474–1479.PubMedCrossRefGoogle Scholar
  35. 35.
    Tunick PA, Culliford AT, Lamparello PJ, Kronzon I. Atheromatosis of the aortic arch as an occult source of multiple systemic emboli. Ann Intern Med. 1991; 114: 391–392.PubMedGoogle Scholar
  36. 36.
    Karalis DG, Chanddrasekaran K, Victor MF, et al. Recognition and embolic potential of intraaortic atherosclerotic debris. J Am Coll Cardiol. 1991; 17: 73–78.PubMedCrossRefGoogle Scholar
  37. 37.
    Marshall JNG, Barzilai B, Kouchoukos N, Saffitz J. Intraoperative ultrasonic imaging of the ascending aorta. Ann Thorac Surg. 1989; 48: 339–344.PubMedCrossRefGoogle Scholar
  38. 38.
    Gardner TJ, Hornreffer PJ, Manolio TA, et al. Stroke following coronary artery bypass grafting: a ten-year study. Ann Thorac Surg. 1985; 40: 574–581.PubMedCrossRefGoogle Scholar
  39. 39.
    Mohr JP. Lacunes. Stroke. 1982; 13: 3–11.PubMedCrossRefGoogle Scholar
  40. 40.
    Caplan LR, Gorelick PB, Hier DB. Race, sex, and occlusive vascular disease: a review. Stroke. 1986; 17: 648–655.PubMedCrossRefGoogle Scholar
  41. 41.
    Chambers BR, Norris JW. Outcome in patients with asymptomatic neck bruits. N Engl J Med. 1986; 315: 860–865.PubMedCrossRefGoogle Scholar
  42. 42.
    Caplan LR, Pessin MS. Symptomatic carotid artery disease and carotid endarterectomy. Annu Rev Med. 1988; 39: 273–299.PubMedCrossRefGoogle Scholar
  43. 43.
    Caplan LR. TIAs: we need to return to the question “What’s wrong with Mr. Jones?” Neurology. 1988; 38: 793–799.Google Scholar
  44. 44.
    Caplan LR. Cerebrovascular disease: large artery occlusive disease. In: Appel S, ed. Current Neurology. Chicago: Year Book Medical Publishers, 1988; 3: 179–226.Google Scholar
  45. 45.
    Fisher CM. Observations of the fundus oculi in transient monocular blindness. Neurology. 1959; 9: 333–347.PubMedCrossRefGoogle Scholar
  46. 46.
    Pessin MS, Duncan G, Mohr J, et al. Clinical and angiographic features of carotid transient ischemic attacks. N Engl J Med. 1977; 296: 358–362.PubMedCrossRefGoogle Scholar
  47. 47.
    Marzewski D, Furlan A, St Louis P, et al. Intracranial internal carotid artery stenosis: long term prognosis. Stroke. 1982; 13: 821–824.PubMedCrossRefGoogle Scholar
  48. 48.
    Caplan LR, Babikian V, Helgason C, et al. Occlusive disease of the middle cerebral artery. Neurology. 1985; 35: 975–982.PubMedCrossRefGoogle Scholar
  49. 49.
    Bladin P, Berkovic S. Striatocapsular infarction: large infarcts in the lenticulostriate arterial territory. Neurology. 1984; 34: 1423–1430.PubMedCrossRefGoogle Scholar
  50. 50.
    Gacs G, Gox A, Barnett HJM, et al. Occurrence and mechanisms of occlusion of the anterior cerebral artery. Stroke. 1983; 14: 952–959.PubMedCrossRefGoogle Scholar
  51. 51.
    Helgason C, Caplan LR, Goodwin J, et al. Anterior choroidal territory infarction: case reports and review. Arch Neurol. 1986; 43: 681–686.PubMedCrossRefGoogle Scholar
  52. 52.
    Hennerici M, Kleman C, Rautenberg W. The subclavian steal phenomenon: a common vascular disorder with rare neurologic deficits. Neurology. 1988; 38: 669–673.PubMedCrossRefGoogle Scholar
  53. 53.
    Caplan LR, Pessin MS, Mohr JP. Vertebrobasilar occlusive disease in stroke pathophysiology, diagnosis, and management. In: Barnett HJ, Mohr JP, Stein BM, Yatsu F, eds. New York: Churchill-Livingstone; 1992: 443–515.Google Scholar
  54. 54.
    Caplan LR. Bilateral distal vertebral artery occlusion. Neurology. 1983; 33: 552–558.PubMedCrossRefGoogle Scholar
  55. 55.
    Moufarrij N, Little J, Furlan A, et al. Vertebral artery stenosis: long term follow-up. Stroke. 1984; 15: 260–263.PubMedCrossRefGoogle Scholar
  56. 56.
    Caplan LR, Amarenco P, Rosengart A, et al. Embolism from vertebral artery origin occlusive disease. Neurology. 1992; 42: 1505–1512.PubMedCrossRefGoogle Scholar
  57. 57.
    Caplan LR, Tettenborn B. Vertebrobasilar occlusive disease: review of selected aspects. 2. Posterior circulation embolism. Cerebrovasc Dis. 1992; 2: 320–326.CrossRefGoogle Scholar
  58. 58.
    Pessin MS, Caplan LR. Basilar artery stenosis—middle and distal segments. Neurology. 1987; 37: 1742–1746.PubMedCrossRefGoogle Scholar
  59. 59.
    Caplan LR. Occlusion of the vertebral or basilar artery. Stroke. 1979; 10: 277–282.PubMedCrossRefGoogle Scholar
  60. 60.
    Castaigne P, L’hermitte F, Gautier J, et al. Arterial occlusions in the vertebral basilar system. Brain. 1973; 96: 133–154.PubMedCrossRefGoogle Scholar
  61. 61.
    Pessin MS, Lathi E, Cohen MB, et al. Clinical features and mechanisms of occipital infarction in the posterior cerebral artery territory. Ann Neurol. 1987; 21: 290–299.PubMedCrossRefGoogle Scholar
  62. 62.
    Pessin MS, Kwan E, DeWitt LD, et al. Posterior cerebral artery stenosis. Ann Neurol. 1987; 21: 85–89.PubMedCrossRefGoogle Scholar
  63. 63.
    De Witt DL, Wechsler L. Transcranial Doppler. Stroke. 1987; 22: 31–36.Google Scholar
  64. 64.
    Caplan LR, Brass LM, De Witt LD, et al. Transcranial Doppler ultrasound: present status. Neurology. 1990; 40: 696–700.PubMedCrossRefGoogle Scholar
  65. 65.
    Caplan LR, Wilpert SM. Conventional cerebral angiography: occlusive cerebrovascular disease. In: Wood JH, ed. Cerebral Blood Flow: Physiologic and Clinical Aspects. New York: McGraw-Hill; 1987; 23: 356–384.Google Scholar
  66. 66.
    Grau AJ, Buggle F, Heindl S, et al. Recent infection as a risk factor for cerebrovascular ischemia. Stroke. 1995; 26: 373–379.PubMedCrossRefGoogle Scholar
  67. 67.
    Caplan LR. Neurology of the acute cardiac. In: Donoso E, Cohen S, eds. Critial Cardiac Care. New York: Stratton International Medical Books; 1979: 183–187.Google Scholar
  68. 68.
    Wolf P, Dyken M, Barnett HJM, et al. Risk factors in stroke. Stroke. 1984; 15: 1105–1111.Google Scholar
  69. 69.
    Caplan LR. Chronic vascular dementia. In: Jones HR, ed. Primary Care: Cerebrovascular Disorders. Philadelphia: WB Saunders; 1979: 843–848.Google Scholar
  70. 70.
    Caplan LR, Schoeme W. Subcortical arteriosclerotic encephalopathy (Binswanger’s disease): clinical features. Neurology. 1978; 28: 1206–1217.PubMedCrossRefGoogle Scholar
  71. 71.
    Caplan LLR. Binswanger’s disease: current opinion in neurology and neurosurgery. Gowers Academic J. 1988; 1: 57–62.Google Scholar
  72. 72.
    Caplan LR. Binswangers disease revisited. Neurology. 1995; 45: 626–633.PubMedCrossRefGoogle Scholar

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© Springer Science+Business Media New York 1997

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  • Louis Caplan

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