Stroke Part I: Basic and epidemiological aspects: Handbook of Clinical Neurology (Handbook of Clinical Neurology)

Book Details

Title	Stroke, Part I: Basic and Epidemiological Aspects
Editor	Marc Fisher
Series Editors	Michael J. Aminoff, François Boller, Dick F. Swaab
Publisher	Elsevier
Year	2008
Edition	1st Edition
Language	English
Pages	433
ISBN	9780444520036
Genre	Neurology, Clinical Medicine
Series	Handbook of Clinical Neurology, Volume 92
Size	30.6 MB
Extension	PDF

Summary

Stroke, Part I: Basic and Epidemiological Aspects is the ninety-second volume of the Handbook of Clinical Neurology series, published by Elsevier in 2008 and edited by Dr. Marc Fisher, a leading translational researcher in cerebrovascular disease [citation:1][citation:2]. This volume is the first of three parts dedicated to stroke within the handbook, establishing the scientific and epidemiological groundwork upon which the subsequent volumes on clinical manifestations and management are built [citation:3]. It arrives at a moment of significant transformation in the stroke field, when advances in neuroimaging, genetics, and acute intervention were beginning to reshape both understanding and treatment of cerebrovascular disorders. The book serves as both a historical record of these advances and a foundational reference for researchers and clinicians seeking a comprehensive overview of stroke science.

The volume opens with a historical perspective that traces how stroke was once viewed as an "experiment of nature"—a tragic but instructive event that revealed the functional anatomy of the brain—before the era of therapeutic optimism began [citation:1]. From there, it moves into a detailed exploration of the basic science of stroke, covering the biochemical cascades triggered by ischemia, the concept of the ischemic penumbra, mechanisms of excitotoxicity and apoptosis, and the role of inflammation and genetics in determining outcomes. The section on epidemiology examines the distribution and determinants of stroke across populations, addressing risk factors, incidence and prevalence patterns, and the global burden of the disease. These chapters provide the empirical foundation necessary for understanding why stroke remains one of the leading causes of death and disability worldwide.

What distinguishes this volume is its translational orientation, bridging laboratory investigation and clinical application. The chapters on neuroimaging describe how technologies such as diffusion-weighted and perfusion MRI have revolutionized the ability to visualize ischemic injury in real time, allowing researchers to track the evolution of the penumbra and evaluate the effects of therapies in animal models [citation:8]. This integration of basic science with imaging and clinical epidemiology reflects Dr. Fisher's own research trajectory, which focused on using MRI to assess the ischemic penumbra and the effects of therapeutic interventions in stroke models [citation:4]. For basic researchers, the volume provides a solid foundation for future investigations; for clinicians, it offers a deeper understanding of the pathophysiological mechanisms that underlie the neurological deficits they observe in practice [citation:1].

The primary audience for this volume includes neurologists, neurology residents, stroke researchers, and neuroscientists working in cerebrovascular disease [citation:4]. It is also valuable for clinicians in related fields such as neuroradiology, vascular surgery, and critical care medicine who need a thorough grounding in the basic science and epidemiology of stroke. The book assumes a background in medicine or neuroscience and is not intended for general readers. As part of the Handbook of Clinical Neurology, it maintains the series' high standards of editorial rigor and comprehensive coverage, making it a reliable reference for those who require more than a superficial understanding of stroke mechanisms and population-level risk.

Dr. Fisher's expertise lends the volume considerable authority. Having spent decades at the University of Massachusetts Medical School leading a stroke modeling laboratory and organizing the influential STAIR (Stroke Treatment and Academic Roundtable) conferences, he brings a uniquely informed perspective on what researchers and clinicians need to know about the basic science of stroke [citation:4][citation:15]. The book remains a standard reference in medical libraries and neurology departments, valued for its ability to explain complex pathophysiological concepts in a manner that is accessible to those with appropriate training. For anyone seeking a comprehensive foundation in the basic and epidemiological aspects of stroke, this volume represents an essential starting point.

Key Features

• The volume is part of the Handbook of Clinical Neurology series and constitutes Volume 92, the first of three parts dedicated to stroke [citation:1][citation:2].
• It opens with a historical perspective on how stroke was understood before modern therapeutic and imaging capabilities, providing context for contemporary advances.
• The basic science section covers the biochemical and molecular mechanisms of ischemic injury, including excitotoxicity, apoptosis, inflammation, and the ischemic penumbra.
• It addresses the role of genetics and gender differences in stroke susceptibility and outcomes, reflecting the growing understanding of individualized risk factors.
• The epidemiology section examines the global burden of stroke, risk factors, incidence and prevalence patterns, and the evolution of prevention strategies.
• Chapters on neuroimaging describe the use of diffusion-weighted and perfusion MRI to visualize ischemic injury and track the evolution of the penumbra in both animal models and patients [citation:8].
• It covers the biochemical background of stroke, including the role of free radicals, nitric oxide, and other mediators of cellular damage.
• The volume is edited by Marc Fisher, a professor of neurology and radiology who led a stroke modeling laboratory for 25 years and served as Editor-in-Chief of the journal Stroke [citation:4].
• The series editors are Michael J. Aminoff, François Boller, and Dick F. Swaab, ensuring editorial consistency across the Handbook of Clinical Neurology [citation:1].
• It provides a translational perspective, linking laboratory findings to clinical epidemiology and imaging, making it valuable for both basic researchers and practicing clinicians.
• The book includes coverage of vascular anatomy and pathology, offering a structural basis for understanding the patterns of ischemic injury.
• It is designed as a reference volume, with chapters structured to facilitate both comprehensive study and targeted consultation.
• The volume was published during a period of rapid advancement in stroke research, capturing the state of knowledge at a pivotal moment in the field.

About Author

Dr. Marc Fisher is a Professor of Neurology and Radiology at the University of Massachusetts Medical School in Worcester, Massachusetts, where he spent 36 years before retiring in 2014 [citation:4]. He holds a Bachelor of Science in Biology and Medicine from Cornell University and an MD from the State University of New York at Syracuse, followed by an internship at the University of Wisconsin Hospitals and neurology training at the Medical Center Hospital of Vermont [citation:8]. For 25 years, he led a stroke modeling laboratory focused on using MRI technology to evaluate the ischemic penumbra and the effects of various therapies on the evolution of ischemic injury, training more than 25 research fellows from around the world [citation:4].

Dr. Fisher has published more than 330 peer-reviewed papers with an h-index of 80 and has participated in numerous clinical trials as a principal investigator or steering committee member [citation:4]. He organized the influential STAIR (Stroke Treatment and Academic Roundtable) meetings, which established recommendations for preclinical modeling practices in ischemic stroke and for clinical trial design [citation:15]. He served as Editor-in-Chief of the journal Stroke from 2010 to 2020 and continues as a senior consulting editor. He is currently a part-time member of the neurology faculty at Beth Israel Deaconess Medical Center in Boston and a Professor of Neurology (part-time) at Harvard Medical School, where he continues to see patients and teach residents and stroke fellows [citation:4].

Related Books

• Stroke, Part II: Clinical Manifestations and Pathogenesis — Marc Fisher (Editor)
• Stroke, Part III: Investigation and Management — Marc Fisher (Editor)
• Handbook of Clinical Neurology: Neuroimaging, Part I — Joseph C. Masdeu and R. Gilberto Gonzalez (Editors)
• Warlow's Stroke: Practical Management — Graeme Hankey, et al.
• Caplan's Stroke: A Clinical Approach — Louis R. Caplan
• Stroke: Pathophysiology, Diagnosis, and Management — James C. Grotta, et al.
• Bradley's Neurology in Clinical Practice — Robert B. Daroff, et al.
• Localization in Clinical Neurology — Paul W. Brazis, et al.

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FAQ

Q : Is this volume a standalone book or part of a larger series?

R : Stroke, Part I is Volume 92 of the Handbook of Clinical Neurology, a long-running and highly respected series that covers the entire field of clinical neurology [citation:1]. It is the first of three volumes dedicated specifically to stroke, with Part II addressing clinical manifestations and pathogenesis and Part III covering investigation and management [citation:3]. While the volume can be used independently as a reference on the basic science and epidemiology of stroke, readers seeking comprehensive coverage of cerebrovascular disease will benefit from consulting all three parts. The series editors are Michael J. Aminoff, François Boller, and Dick F. Swaab.

Q : Who should read this book?

R : The primary audience includes neurologists, neurology residents, stroke researchers, and neuroscientists working in cerebrovascular disease [citation:4]. Clinicians in related fields such as neuroradiology, vascular surgery, and critical care medicine will also find it valuable for understanding the scientific foundations of stroke. The book assumes a background in medicine or neuroscience and is not intended for general readers. Basic researchers will appreciate the comprehensive overview of pathophysiology and epidemiology, while clinicians will gain a deeper understanding of the mechanisms underlying the deficits they observe in practice.

Q : What distinguishes this volume from a general stroke textbook?

R : Unlike general stroke textbooks that attempt to cover the entire field in a single volume, this book focuses exclusively and in depth on the basic science and epidemiology of stroke. This narrow scope allows for detailed coverage of topics that often receive only cursory treatment elsewhere, such as the biochemical cascades of ischemic injury, the genetics of stroke, and the use of MRI to visualize the ischemic penumbra [citation:8]. The chapters are written by specialists who emphasize the pathophysiological basis of clinical findings, helping readers understand not just what happens but why. This translational approach is a hallmark of the Handbook of Clinical Neurology series.

Q : What is Dr. Marc Fisher's expertise in the field of stroke?

R : Dr. Marc Fisher is a highly respected stroke researcher and clinician who spent 36 years at the University of Massachusetts Medical School, where he led a stroke modeling laboratory for 25 years [citation:4]. He organized the influential STAIR meetings that established recommendations for preclinical stroke research and clinical trial design [citation:15]. He served as Editor-in-Chief of the journal Stroke from 2010 to 2020 and has published more than 330 peer-reviewed papers with an h-index of 80. He is currently a Professor of Neurology (part-time) at Harvard Medical School and a part-time member of the neurology faculty at Beth Israel Deaconess Medical Center.

Q : Does the book cover both ischemic and hemorrhagic stroke?

R : This first volume focuses primarily on the basic science and epidemiology of ischemic stroke, reflecting the emphasis of Dr. Fisher's own research and the broader stroke research community during the period of publication. The pathophysiological mechanisms described, including excitotoxicity, apoptosis, and the ischemic penumbra, are most directly relevant to ischemic injury. Hemorrhagic stroke is addressed in more detail in the subsequent volumes, particularly Part II, which covers clinical manifestations including hemorrhagic stroke syndromes, and Part III, which addresses management. Readers seeking comprehensive coverage of hemorrhagic stroke should consult those volumes.

Q : Are the chapters written by multiple authors or by Dr. Fisher alone?

R : Like most volumes in the Handbook of Clinical Neurology series, this book is an edited collection with chapters contributed by multiple specialists in the field. Dr. Marc Fisher serves as the volume editor, responsible for the overall structure, selection of topics, and editorial consistency [citation:1]. This multi-author approach brings together expertise from different institutions and subspecialties, ensuring that each topic is addressed by someone with direct research or clinical experience in that area. The series editors provide additional oversight to maintain the high standards of the handbook.

Q : Is the book still relevant given advances in stroke research since 2008?

R : While stroke research has continued to evolve since the book's publication—particularly in areas such as endovascular thrombectomy and advanced neuroimaging—the fundamental scientific principles and epidemiological patterns it covers remain largely valid. The biochemical mechanisms of ischemic injury, the concept of the penumbra, and the population-level risk factors for stroke do not change rapidly. The book remains a valuable reference for understanding the scientific foundations of stroke and the reasoning behind diagnostic and therapeutic approaches. Readers should supplement it with more recent literature for the latest clinical trial evidence and treatment recommendations.

Q : What is the significance of the historical perspective chapter?

R : The opening chapter on historical perspective provides essential context for understanding how the field arrived at its current state [citation:1]. It traces the evolution of stroke from an event viewed as an "experiment of nature" that revealed brain anatomy, through periods of therapeutic nihilism, to the modern era of active intervention and prevention. This historical grounding helps readers appreciate why certain questions are asked, why certain approaches were abandoned, and how the current paradigm emerged. It also serves as a reminder that scientific progress is incremental and often involves overturning long-held assumptions, a lesson that remains relevant for contemporary researchers and clinicians.