Stroke and cerebrovascular disease

Strokes result from occlusion or rupture of blood vessels in the brain and are a leading cause of death and disability in the United States (US, Broderick et al., 1998). There are around 700,000 new and recurrent strokes per year in the US, with costs related to stroke estimated to be over $60 billion in 2007 (Rosamond et al., 2007). Around 80-85% of strokes are ischemic and 15-20% of strokes are hemorrhagic. Over the past three decades neuroimaging methods such as computed tomography (CT) and magnetic resonance imaging (MRI) have enormously improved the rapid and accurate diagnosis of ischemic and hemorrhagic stroke (Figure 31.1). More recently, non-invasive vascular imaging methods such as CT angiography (CTA) and MR angiography (MRA) have proven invaluable for the detection of vascular stenoses in the carotid arteries. But the therapeutics of stroke has lagged behind.