Preface

Stroke continues to be a major public health issue. It is the third leading cause of death and disability across the globe. Its early identification, early treatment, and prevention are major issues that confront a treating physician. Early recognition of the disease involves public awareness, an emergency transport system, a good and well-rehearsed stroke care program, and an organized rehabilitation setup both at the hospital and in the community. We have understood the importance of early intervention and the quote 'time is brain' has been understood by neurologists across the globe and by most physicians. Our endeavor now should be directed to the public at large and paramedics in particular. Until recently, a stroke was considered to be an illness of old people but we are diagnosing an increasing number of such cases in young people. Carmen et al. in their article on ischemic strokes in young people have dealt with this issue in detail. Aphasia and difficulty in swallowing, though an important component of stroke-related disabilities have not been stressed in detail in current textbooks. Cătălin et al. in their article on vascular aphasia have elaborated on this problem.

Although a stroke is a common condition, the availability of a neurologist or stroke specialist is quite scarce. Today, management of a suspected case of stroke is done by a specialist team of medical and paramedical personnel who are trained and tuned to act swiftly without wasting any time. However, the availability of such facilities is limited by cost and geographical distance. To deal with and manage it in the periphery, telestroke is a novel concept. Through this, many patients now have the access to a qualified stroke specialist in remote areas. Aliza et al. in their article 'Telestroke: A New Paradigm ' have highlighted its application.

Advances in imaging, newer therapeutic agents, and endovascular management have revolutionized the management of ischemic stroke. Intravenous thrombolysis in a window period of four and half hours is a revolutionary development and now it is possible to salvage the ischemic brain and save many patients from death and gross disabilities. Irina et al. have reviewed many burning issues related to managing ischemic strokes and have given us some practical tips. Protection of brain tissue from ischemic damage during various phases i.e. pre-hospital phase, during hospitalization, and poststroke phase, is a long-felt need. Unfortunately, none of the available agents or procedures have been proved clinically and this has been highlighted in the last article.

Currently, we are witnessing a new era in the management of strokes and I am hopeful that continued research will get us to a satisfactory solution. This book along with another book from IntechOpen titled 'Ischemic Stroke of Brain' is a great source for postgraduate medical students in medicine and neurology who have an interest in stroke care.

> **Dr. Pratap Sanchetee, MD, DM (Neurology)** Consultant Neurologist, Sanchetee Neurology Research Institute, Rajasthan, India

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Section 1

Ischemic Stroke - Diagnosis

## Section 1
