Stroke is a bewildering experience for everyone. Much of the research into its prevention and treatment remains confused. While it is generally thought that addressing the classical causes such as high blood pressure and raised cholesterol levels provides the most effective prevention, these account for only 50 per cent of the total risk factors.
Those who have had major surgery, especially to the heart or lower limbs, have a greatly increased risk of developing thrombosis, which can eventually translate into stroke. Drugs which are currently administered to combat thrombosis cause greater morbidity and mortality, especially in elderly patients. Often these patients, or their family members are asked, in the grip of acute stroke, to make the impossible choice between the risk of early death or the possibility of less disability in the longer term.Physicians and researchers need to direct their attention away from concerns about what it might cost to hospitalize and treat stroke patients, and look to the evidence about the cost, in human terms, of inappropriate treatments, which save only a handful lives out of every thousand patients treated and leave many more with a substantially reduced quality of life. A more positive step would be a sharpening of their clinical skills and a return to "whole person" medicine as the ultimate prevention.