The practice of medicine is an art. Care of each individual patient must take into account a variety of factors that make that person and his or her illness unique. Yet, if we cannot learn from previous patients, we will never be able to improve our ability to care for new ones that we encounter. Thus, each time we are faced with a treatment decision, it is incumbent on us to ask: What evidence is available to allow us to choose between treatment alternatives? In some cases, the evidence will be excellent and in other cases it will be non-existent. But whatever the quality and quantity of the evidence, the skilled physician will be familiar with it and use it as the basis for individual treatment decisions.

In this series of lectures, we will provide a discussion of the current state of evidence supporting different treatments for the most common types of cerebrovascular disease. The evidence that we will consider is based on studies that describe the association between treatments and clinical outcomes in human subjects. Such empirical data require no assumption regarding mechanisms of disease or treatment effect. Since they require no assumptions, they are the most valid means to judge the efficacy of therapeutic interventions.

Presentations

Evidence Based Medicine Overview

• Principles of Evidence Based Medicine 2006

Acute Ischemic Stroke

• Thrombolytic Therapy 2006
  
• Antithrombotic Therapy 2006
  
• Diagnostic Testing

Hemorrhagic Stroke

• Intracerebral Hemorrhage 2006
  
• Subarachnoid Hemorrhage 2006

Stroke Prevention

• Antithrombotic Therapy in the Prevention of Cardioembolic Stroke
  
• Medicine, Surgery, and Stenting for Carotid Atherosclerotic Disease
  
• Evidence-Based Use of Antiplatelet Therapy in Secondary Stroke Prevention
  
• Evidence-Based Use of Medical Therapy in Secondary Stroke Prevention
  2006

Stroke Rehabilitation

• Rehabilitation Strategies Following Stroke

References

A full citation list with links to PubMed is available on the References page for each discussion. Additionally, a comprehensive list incorporating references from all presentations can be found on the following page: http://www.strokecenter.org/management/citations.html.

Terms of Use

Evidence-Based Treatment of Cerebrovascular Disease is based on a Summer lecture series of the same name presented by the clinicians of the Stroke Center at Barnes-Jewish Hospital and Washington University School of Medicine in St. Louis, Missouri. These physicians have generously agreed to offer this material to the Internet Stoke Center as an educational service to the visitors of this site. All material presented herein is the intellectual property of the authors named, and any reproduction or republication without permission will be considered a copyright breach. Permission may be granted to professionals to borrow material from this site for educational purposes and/or presentations; we just ask that an email be sent detailing both the desired material and the intended use. Please direct all comments, questions, and requests to David Murray, Managing Editor of the Internet Stroke Center.