Warlow’s Stroke To Strong and Angela: for your unwavering support; and to Tim, Gem, Tess, and Stella: for being behind everything I do. Fan Z. Caprio To Prof. Charles Warlow who inspired me and many others to become a stroke trialist and to my wife, Vidula Verma, who has tolerated being married to one. Christopher Chen To my late father, Harold L. Gorelick, for his innovative spirit, common sense, life accomplishments, and love of family. Philip B. Gorelick To the patients, teachers and colleagues who taught me everything I know; and to Lindsay, Calum and Magnus, for their support and forebearance. Malcolm Macleod To Prof. Charles Warlow, who is not only a great neurologist, but also a great sailor. Heinrich Mattle Warlow’s Stroke Practical Management Fourth Edition Edited by Graeme J. Hankey MBBS, MD, FRACP, FRCPE, FAHA, FESO, FAAHMS Professor of Neurology, Medical School, The University of Western Australia, Perth, Australia Consultant Neurologist, Sir Charles Gairdner Hospital, Perth, Western Australia Malcolm Macleod BSc(Hons), MBChB, PhD, FRCP Professor of Neurology and Translational Neurosciences at the University of Edinburgh, and Honorary Consultant Neurologist and Head of Neurology, NHS Forth Valley, UK Philip B. Gorelick MD, MPH, FACP, FAHA, FAAN, FANA Professor Translational Science and Molecular Medicine at Michigan State University, Grand Rapids, MI, USA Adjunct Professor, Davee Department of Neurology, Northwestern Feinberg School of Medicine, Chicago, IL, USA International Fellow, Population Health Research Institute affiliated with McMaster University Faculty of Health Sciences and Hamilton Health Sciences, Hamilton, ON, Canada Professor Emeritus, Department of Neurology and Rehabilitation, University of Illinois College of Medicine, Chicago, IL, USA Christopher Chen BA, BMBCh, FRCP Director, Memory Aging & Cognition Centre, National University Health System, Singapore Associate Professor, Department of Pharmacology, National University of Singapore, Singapore Senior Consultant Neurologist, Department of Psychological Medicine, National University Hospital, Singapore Fan Z. Caprio MD Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA Heinrich Mattle MD, FRCPE, FAHA, FESO Professor, Senior Consultant, Department of Neurology, University of Bern, Bern, Switzerland This edition first published 2019 © 2019 by John Wiley & Sons Ltd Edition History C. Warlow, J. van Gijn, M. Dennis, J. Wardlaw, J. Bamford, G. Hankey, P. Sandercock, G. Rinkel, P. Langhorne, C. Sudlow, P. Rothwell. Published by Blackwell Publishing (3e, 2007) All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by law. Advice on how to obtain permission to reuse material from this title is available at http://www.wiley.com/go/permissions. 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Warlow … [et al.]. 3rd ed. c2008. | Includes bibliographical references and index. | Identifiers: LCCN 2018039802 (print) | LCCN 2018040801 (ebook) | ISBN 9781118492420 (Adobe PDF) | ISBN 9781118492413 (ePub) | ISBN 9781118492222 (hardcover) Subjects: | MESH: Stroke–therapy | Intracranial Hemorrhages–therapy | Ischemic Attack, Transient–therapy Classification: LCC RC388.5 (ebook) | LCC RC388.5 (print) | NLM WL 356 | DDC 616.8/1–dc23 LC record available at https://lccn.loc.gov/2018039802 Cover images: MR images of a 66-year-old woman with an acute stroke because of a proximal middle cerebral artery occlusion on the right, visible on the MR angiogram (right). The diffusion-weighted image (left) shows the core of the infarct and the perfusion-weighted image (center) shows the perfusion deficit. The perfusion deficit is much larger than the core of the infarct and demonstrates a large volume of brain tissue that was salvaged with successful reperfusion. Images courtesy of Professor Jan Gralla, Department of Diagnostic and Interventional Neuroradiology, University of Bern, Inselspital, Bern, Switzerland. Cover design by Wiley Set in 10/12 pt Warnock by SPi Global, Pondicherry, India 10 9 8 7 6 5 4 3 2 1 v Contents Contributors vii Acknowledgments xi Abbreviations xiii 1 Introduction 1 2 Development of knowledge about cerebrovascular disease 7 Jan van Gijn 3 Is it a vascular event and where is the lesion? 37 Simon Jung and Heinrich P. Mattle 4 Which arterial territory is involved? 129 John C.M. Brust 5 What is the role of imaging in acute stroke? 171 5A ­Neuroimaging 172 Marwan El‐Koussy 5B ­Ultrasound of the extra‐ and intracranial arteries 224 Georgios Tsivgoulis and Apostolos Safouris 5C ­Cardioembolic stroke 241 Issam Mikati and Zeina Ibrahim 6 What caused this transient or persisting ischemic event? 267 Fernando D. Testai 7 Unusual causes of ischemic stroke and transient ischemic attack 345 Fan Z. Caprio and Chen Lin 8 What caused this intracerebral hemorrhage? 399 Farid Radmanesh and Jonathan Rosand 9 What caused this subarachnoid hemorrhage? 437 Matthew B. Maas and Andrew M. Naidech 10 A practical approach to the management of stroke and transient ischemic attack 455 H. Bart van der Worp and Martin Dennis 11 What are this patient’s problems? A problem‐based approach to the general management of stroke 481 Yannie Soo, Howan Leung, and Lawrence Ka Sing Wong vi Contents 12 Have the patient’s cognitive abilities been affected? 579 Leonardo Pantoni 13 Specific treatment of acute ischemic stroke 587 Eivind Berge and Peter Sandercock 14 Specific treatment of intracerebral hemorrhage 657 Shoichiro Sato and Craig S. Anderson 15 Specific treatment of aneurysmal subarachnoid hemorrhage 679 Gregory Arnone and Sepideh Amin‐Hanjani 16 Specific interventions to prevent intracranial hemorrhage 723 Preston W. Douglas, Clio A. Rubińos, and Sean Ruland 17 Preventing recurrent stroke and other serious vascular events 745 Cathra Halabi, Rene Colorado, and Karl Meisel 18 Rehabilitation after stroke: evidence, practice, and new directions 867 Coralie English, Audrey Bowen, Debbie Hébert, and Julie Bernhardt 19 The organization of stroke services 879 Peter Langhorne, Jeyaraj Durai Pandian, and Cynthia Felix 20 Reducing the impact of stroke and improving public health 933 Graeme